Provider Demographics
NPI:1437338324
Name:MOLSEED, LEAH JOAN (PT)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:JOAN
Last Name:MOLSEED
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4380 SW MACADAM AVE
Mailing Address - Street 2:SUITE 565
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-6403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4380 SW MACADAM AVE
Practice Address - Street 2:SUITE 565
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-6403
Practice Address - Country:US
Practice Address - Phone:971-244-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR5543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist