MEDICARE: ILEANA GRACIELA DE LEON

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
1	171R00000X	Interpreter	MC56330	WA

General Provider Information

NPI Number	:	1457022105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ILEANA GRACIELA DE LEON

Provider Business Mailing Address
First Line	:	11520 GREENWOOD AVE N APT 102
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-8660
Country	:	US
Telephone Number	:	206-334-2404
Fax Number	:

Provider Business Practice Location Address
First Line	:	11520 GREENWOOD AVE N APT 102
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-8660
Country	:	US
Telephone Number	:	206-334-2404
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	09/22/2021

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Directions to “ ILEANA GRACIELA DE LEON ” Practice Location

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