Provider Demographics
NPI:1508319583
Name:LEONARD, BRANDON (MSW)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:LEONARD
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11211 SE 82ND AVE
Mailing Address - Street 2:SUITE O
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7624
Mailing Address - Country:US
Mailing Address - Phone:503-557-5831
Mailing Address - Fax:
Practice Address - Street 1:11211 SE 82ND AVE
Practice Address - Street 2:SUITE O
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7624
Practice Address - Country:US
Practice Address - Phone:503-557-5831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical