Individual
ABIGAIL ROSE LEI BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1942 NW KEARNEY ST STE 11, PORTLAND, OR 97209-1463
(503) 610-5567
Mailing address
1942 NW KEARNEY ST, PORTLAND, OR 97209-1426
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C10900
OR
Other
Enumeration date
04/22/2021
Last updated
12/11/2025
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