Healthcare Provider Details

I. General information

NPI: 1588543235
Provider Name (Legal Business Name): SHEILENA ANN MARIE LEAGUE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2025
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7024 27TH ST W STE B
UNIVERSITY PLACE WA
98466-5216
US

IV. Provider business mailing address

6470 19TH ST W APT E
TACOMA WA
98466-6196
US

V. Phone/Fax

Practice location:
  • Phone: 253-343-8945
  • Fax:
Mailing address:
  • Phone: 253-343-8945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: