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1790921005
NICKY JO LEEBORG
PORTLAND, OR
NPI
1790921005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: OR MD27627)
Enumeration Date
2008-12-17
Last Update Date
2022-02-01
Business Address
Dr. NICKY JO LEEBORG M.D.
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-2310
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Mailing Address
Dr. NICKY JO LEEBORG M.D.
3181 SW SAM JACKSON PARK RD
PORTLAND, OR 97239-3011
Phone number: 503-494-2310
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