Provider Demographics
NPI:1548021330
Name:HAYTON, LESLIE BAILEY (PT)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:BAILEY
Last Name:HAYTON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11879 NE 163RD PL
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-6495
Mailing Address - Country:US
Mailing Address - Phone:206-794-6786
Mailing Address - Fax:
Practice Address - Street 1:11879 NE 163RD PL
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-6495
Practice Address - Country:US
Practice Address - Phone:206-794-6786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-18
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00003903225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist