Individual
MR. NICHOLAS LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1605 WOODRIDGE DR SE, PORT ORCHARD, WA 98366
(360) 443-2399
Mailing address
1605 WOODRIDGE DR SE, PORT ORCHARD, WA 98366-3818
(360) 443-2399
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
60666287
WA
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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