Provider Demographics
NPI:1205269867
Name:LEGGETT, GIULIA
Entity type:Individual
Prefix:
First Name:GIULIA
Middle Name:
Last Name:LEGGETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 SE 8TH AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4250
Mailing Address - Country:US
Mailing Address - Phone:503-681-4233
Mailing Address - Fax:503-681-4234
Practice Address - Street 1:364 SE 8TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4250
Practice Address - Country:US
Practice Address - Phone:503-681-4233
Practice Address - Fax:503-681-4234
Is Sole Proprietor?:No
Enumeration Date:2013-08-17
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA158608207R00000X
390200000X
ORMD201958207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program