Individual
CARLI VAN LEISHOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2929 MCDOUGALL AVE, ENUMCLAW, WA 98022-7410
(360) 802-7104
Mailing address
6222 S ALDER ST APT 3, TACOMA, WA 98409-4117
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
60781959
WA
Other
Enumeration date
09/17/2021
Last updated
09/17/2021
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