Individual
EDITH LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2925 NE 77TH PL, PORTLAND, OR 97213-5953
(503) 215-5684
(503) 512-0880
Mailing address
2925 NE 77TH PL, PORTLAND, OR 97213-5953
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD-D-000545
OR
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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