Individual
HUGH LEONARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
1316 SE 12TH AVE, PORTLAND, OR 97214-3604
(503) 897-1916
(503) 296-2459
Mailing address
1316 SE 12TH AVE, PORTLAND, OR 97214-3604
(503) 897-1916
(503) 296-2459
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-CRM-343
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21-CRM-343
MHACBO
OR
Enumeration date
02/23/2021
Last updated
02/23/2021
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