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NPI Code Detail

MEDICARE: LEAH GESLOIS LMT

MEDICARE: LEAH GESLOIS LMT
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
1225700000XMassage Therapist26020OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1598351991
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH GESLOIS LMT
Provider Business Mailing Address
First Line : 5030 SE STEPHENS ST
Second Line :
City : PORTLAND
State : OR
Zip : 97215-3287
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4230 NE FREMONT ST
Second Line :
City : PORTLAND
State : OR
Zip : 97213-1150
Country : US
Telephone Number : 971-400-6063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2020
Last Update Date : 12/19/2020

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Directions to “ LEAH GESLOIS LMT” Practice Location

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