Provider Demographics
NPI:1144083338
Name:TAYLOR, LESLIE ANN
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:TAYLOR
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 1:2816 41ST ST
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-7911
Mailing Address - Country:US
Mailing Address - Phone:253-719-3861
Mailing Address - Fax:253-719-3861
Practice Address - Street 1:3614 CALIFORNIA AVE SW STE B
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-3780
Practice Address - Country:US
Practice Address - Phone:206-462-5830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program