Provider Demographics
NPI:1225814221
Name:LEONARD, ANNE NOEL (DPT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:NOEL
Last Name:LEONARD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9135 SW BARNES RD STE 361
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6648
Mailing Address - Country:US
Mailing Address - Phone:503-216-2610
Mailing Address - Fax:
Practice Address - Street 1:9135 SW BARNES RD STE 361
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6648
Practice Address - Country:US
Practice Address - Phone:503-216-2610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR650552251X0800X, 2251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurology