Individual
JENNIFER LYNN LESLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
213 NE 10TH ST, MCMINNVILLE, OR 97128-4825
(971) 261-2259
Mailing address
5415 SW WESTGATE DR, PORTLAND, OR 97221-2409
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/06/2021
Last updated
04/28/2022
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