Individual
LESLIE ANN BALDERSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
619 NW 6TH AVE, PORTLAND, OR 97209-3964
(503) 988-3674
(503) 988-5780
Mailing address
421 SW OAK ST., STE. 210, PORTLAND, OR 97204
(503) 988-3663
(503) 988-3015
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
082010783N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22959
—
OR
Enumeration date
03/09/2007
Last updated
03/07/2019
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