Individual
JAMIE NICOLE LEISSNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6700 MARTIN WAY E STE 117, OLYMPIA, WA 98516-5586
(360) 413-6910
Mailing address
6700 MARTIN WAY E STE 117, OLYMPIA, WA 98516-5586
(360) 413-6910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CO61169403
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO61169403
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO61169403
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2188648
—
WA
Enumeration date
09/07/2021
Last updated
07/18/2022
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