Healthcare Provider Details

I. General information

NPI: 1407403272
Provider Name (Legal Business Name): CHRISTINA SUAREZ LEVERIDGE LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2019
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 POINT FOSDICK DR
GIG HARBOR WA
98335-1706
US

IV. Provider business mailing address

14106 MEADOWLARK DR NW
GIG HARBOR WA
98329-4631
US

V. Phone/Fax

Practice location:
  • Phone: 253-400-0218
  • Fax: 253-500-0218
Mailing address:
  • Phone: 619-871-9709
  • Fax: 818-241-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBA61127069
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: