Provider Demographics
NPI:1205548047
Name:GRANGER, LESLIE N (GENETIC COUNSELOR)
Entity type:Individual
Prefix:MRS
First Name:LESLIE
Middle Name:N
Last Name:GRANGER
Suffix:
Gender:F
Credentials:GENETIC COUNSELOR
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:N
Other - Last Name:DURHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GENETIC COUNSELOR
Mailing Address - Street 1:2801 N GANTENBEIN AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-1623
Mailing Address - Country:US
Mailing Address - Phone:503-944-5970
Mailing Address - Fax:
Practice Address - Street 1:501 N GRAHAM ST STE 330B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-2009
Practice Address - Country:US
Practice Address - Phone:503-944-5970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-22
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS