Provider Demographics
NPI:1932939311
Name:FRAZIER, LEANNE
Entity type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:FRAZIER
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 1:3325 SE DIVISION ST APT 204
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1594
Mailing Address - Country:US
Mailing Address - Phone:971-269-6080
Mailing Address - Fax:
Practice Address - Street 1:2250 NW FLANDERS ST STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-5410
Practice Address - Country:US
Practice Address - Phone:503-427-1952
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker