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NPI Code Detail

MEDICARE: REBECCA JILL LEITMAN

MEDICARE: REBECCA JILL LEITMAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251S00000XCommunity/Behavioral Health AgencyLW 60389096WA

General Provider Information

NPI Number : 1164805107
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA JILL LEITMAN
Provider Business Mailing Address
First Line : 656 NW 81ST ST
Second Line :
City : SEATTLE
State : WA
Zip : 98117-4054
Country : US
Telephone Number : 914-471-5610
Fax Number :
Provider Business Practice Location Address
First Line : 2100 24TH AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98144-4637
Country : US
Telephone Number : 206-382-5340
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2015
Last Update Date : 07/08/2015

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Directions to “ REBECCA JILL LEITMAN ” Practice Location

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