Individual
LEISHA DIANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
7019 ALONZO AVE NW, SEATTLE, WA 98117-5323
(206) 769-4363
Mailing address
7019 ALONZO AVE NW, SEATTLE, WA 98117-5323
(206) 769-4363
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
00004859
WA
Other
Enumeration date
07/13/2009
Last updated
07/13/2009
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