Leonardo Daniel Dominguez

NPI #1811565203 in Forest Grove, Oregon

Provider Information

NPI Number: 1811565203
Entity Type: Individual
Name: Leonardo Daniel Dominguez
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jun 14, 2021
Last Updated: Jun 14, 2021

Practice Location

Address: 2043 COLLEGE WAY
City: Forest Grove
State: Oregon
ZIP Code: 97116-1756
Phone: (503) 352-6151

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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