Provider Demographics
NPI:1548532187
Name:LESNIAK, JAMES MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:MICHAEL
Last Name:LESNIAK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 QUILEUTE HEIGHTS LOOP
Mailing Address - Street 2:
Mailing Address - City:LA PUSH
Mailing Address - State:WA
Mailing Address - Zip Code:98350
Mailing Address - Country:US
Mailing Address - Phone:360-374-9035
Mailing Address - Fax:360-374-2644
Practice Address - Street 1:560 QUILEUTE HEIGHTS LOOP
Practice Address - Street 2:
Practice Address - City:LA PUSH
Practice Address - State:WA
Practice Address - Zip Code:98350
Practice Address - Country:US
Practice Address - Phone:360-374-9035
Practice Address - Fax:360-374-2644
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-28
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110003790363A00000X
AK1162363A00000X
WA61084841363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant