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General NPI Number Information
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NPI Number | 1982567152
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Entity Type | Individual
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Provider Name | LESLIE DONNELLY
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Gender | Female
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Dates
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Enumeration Date | 12/04/2025
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 1282 GOODPASTURE ISLAND RD
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City | EUGENE
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State | OR
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Zip | 97401-1774
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Country | US
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Telephone | 541-246-2828
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 SE THREE MILE LN
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City | MCMINNVILLE
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State | OR
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Zip | 97128-6232
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 9837
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License Number State | OR
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