MICHAEL THOMAS LEAKE

PORTLAND, OR
NPI1760769525
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy171100000X Acupuncturist
(Licence:   156585)
Enumeration Date2011-11-08
Last Update Date2011-11-08
Business Address
-- MICHAEL THOMAS LEAKE LAc
3615 NE GRAND AVE
PORTLAND, OR 97212-2104
Phone number: 503-208-5460
Mailing Address
-- MICHAEL THOMAS LEAKE LAc
3615 NE GRAND AVE
PORTLAND, OR 97212-2104
Phone number: 503-208-5460
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