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NPI Code Detail

MEDICARE: MRS. LEANNE GAIL OSBORNE MA

MEDICARE:  MRS. LEANNE GAIL OSBORNE  MA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1083750988
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LEANNE GAIL OSBORNE MA
Provider Business Mailing Address
First Line : PO BOX 12374
Second Line :
City : PORTLAND
State : OR
Zip : 97212-0374
Country : US
Telephone Number : 503-252-5564
Fax Number :
Provider Business Practice Location Address
First Line : 521 SW 11TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97205-2634
Country : US
Telephone Number : 503-944-1207
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2007
Last Update Date : 07/08/2007

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Directions to “ MRS. LEANNE GAIL OSBORNE MA” Practice Location

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