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NPI Code Detail

MEDICARE: LEAH BLOOMBERG DNP, RN, PMHNP-BC

MEDICARE: LEAH BLOOMBERG DNP, RN, PMHNP-BC
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
2163W00000XRegistered Nurse201607796RNOR
3363LP0808XPsychiatric/Mental Health Nurse Practitioner201807305NP-PPOR

General Provider Information

NPI Number : 1346782117
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH BLOOMBERG DNP, RN, PMHNP-BC
Provider Business Mailing Address
First Line : 5 CENTERPOINTE DR STE 400
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-8661
Country : US
Telephone Number : 503-994-1502
Fax Number :
Provider Business Practice Location Address
First Line : 5 CENTERPOINTE DR STE 400
Second Line :
City : LAKE OSWEGO
State : OR
Zip : 97035-8661
Country : US
Telephone Number : 503-994-1502
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2016
Last Update Date : 03/25/2023

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