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General NPI Number Information
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NPI Number | 1588036412
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Entity Type | Individual
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Provider Name | ANYA LEIGH
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Gender | Female
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 10/30/2015
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Provider Practice Location Address
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Address Line | 36506 S SAWTELL RD
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City | MOLALLA
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State | OR
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Zip | 97038-8727
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Country | US
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Telephone | 503-341-8513
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Fax |
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Provider Business Mailing Address
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Address Line | 4235 SE WOODWARD ST
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City | PORTLAND
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State | OR
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Zip | 97206-2231
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Country | US
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Telephone | 503-341-8513
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC173271
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License Number State | OR
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