Provider Demographics
NPI:1548316169
Name:LEGER, KASEY JOANNE (MD)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:JOANNE
Last Name:LEGER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KASEY
Other - Middle Name:JOANNE
Other - Last Name:HENDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:MAILSTOP: MB.8.501
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-5509
Mailing Address - Fax:206-987-3964
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:MAILSTOP: MB.8.501
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-5509
Practice Address - Fax:206-987-3964
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO47843208000000X
TXP71442080P0207X
WAMD.604667092080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX322538501Medicaid
TX322538503Medicaid