Provider Demographics
NPI:1174641518
Name:ARCHER, LEAH JEAN (PT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:JEAN
Last Name:ARCHER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:JEAN
Other - Last Name:BORGERDING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55 COBURG RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2433
Mailing Address - Country:US
Mailing Address - Phone:541-485-8111
Mailing Address - Fax:541-342-6379
Practice Address - Street 1:55 COBURG RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2433
Practice Address - Country:US
Practice Address - Phone:541-485-8111
Practice Address - Fax:541-342-6379
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR60706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR93-0603212OtherTAX ID