Individual
DR. LESLIE E CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
6239 WOODLAWN AVE N, SEATTLE, WA 98103-5716
(206) 588-2814
(206) 432-9751
Mailing address
6239 WOODLAWN AVE N, SEATTLE, WA 98103-5716
(206) 588-2814
(206) 432-9751
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3081
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8897960
PTAN
WA
01
—
G8897961
MEDICARE/ ORGANIZATIONAL PTAN
WA
Enumeration date
11/01/2006
Last updated
07/21/2021
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