Healthcare Provider Details

I. General information

NPI: 1821799305
Provider Name (Legal Business Name): LESLIE GABRIELA PARADA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/13/2023
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 3RD AVE
SEATTLE WA
98121-2385
US

IV. Provider business mailing address

923 112TH ST SW APT F329
EVERETT WA
98204-7870
US

V. Phone/Fax

Practice location:
  • Phone: 206-223-3644
  • Fax: 206-223-1482
Mailing address:
  • Phone: 916-317-5402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: