Individual
DR. NICHOLAS S LESLEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
(253) 761-4201
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-7060
(207) 662-7066
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD183728
OR
2085R0202X
Diagnostic Radiology Physician
Primary
MD60757715
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2082050
—
WA
05
—
500731240
—
OR
Enumeration date
06/23/2011
Last updated
12/17/2021
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