Healthcare Provider Details

I. General information

NPI: 1578812418
Provider Name (Legal Business Name): LESLIE ANN ESPARZA PHARM. D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2012
Last Update Date: 01/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 S 2ND AVE
WALLA WALLA WA
99362-4116
US

IV. Provider business mailing address

1025 S 2ND AVE
WALLA WALLA WA
99362-4116
US

V. Phone/Fax

Practice location:
  • Phone: 509-525-0480
  • Fax:
Mailing address:
  • Phone: 509-525-0480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH 60280958
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: