DR. Nicky Jo Leeborg, M.D. is a student in an organized health care education training program in Portland, OR with 21 years of experience. The provider is an individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. DR. Nicky Jo Leeborg, M.D. NPI is 1790921005. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a female.
Education
Medical School: STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
Graduation Year:2003
The provider's business location address is:
3181 SW SAM JACKSON PARK RD
PORTLAND, OR
ZIP 97239-011
Phone: (503) 494-2310
The NPI 1790921005 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.
The enumeration date for this NPI number is 12/17/2008 and was last updated on 2/1/2022.