Provider Demographics
NPI:1164575890
Name:SCHULTZ, LEANNA BROWN (PA-C)
Entity Type:Individual
Prefix:MS
First Name:LEANNA
Middle Name:BROWN
Last Name:SCHULTZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:LEANNA
Other - Middle Name:MARIE
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7305 SE CIRCUIT DR STE 270
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-1915
Mailing Address - Country:US
Mailing Address - Phone:503-324-9931
Mailing Address - Fax:
Practice Address - Street 1:7305 SE CIRCUIT DR STE 270
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-1915
Practice Address - Country:US
Practice Address - Phone:503-324-9931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01469363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant