Healthcare Provider Details

I. General information

NPI: 1164108627
Provider Name (Legal Business Name): AFTYN LEYDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AFTYN WILLIAMS

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2103 S ATLANTIC ST
SEATTLE WA
98144-3615
US

IV. Provider business mailing address

2103 S ATLANTIC ST
SEATTLE WA
98144-3615
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-2050
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: