Basic Information
| Provider Information | |||||||||
| NPI: | 1598391260 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADDINGTON | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | NOELLE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6200 SW ARCTIC DR | ||||||||
| Address2: | |||||||||
| City: | BEAVERTON | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970059447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5032242184 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2405 NE JOHN OLSEN AVE APT B215 | ||||||||
| Address2: | |||||||||
| City: | HILLSBORO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970066754 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9712754207 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/13/2020 | ||||||||
| LastUpdateDate: | 03/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y |
No ID Information.