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General NPI Number Information
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NPI Number | 1063064889
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Entity Type | Organization
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Legal Business Name | LESHAW CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 11/07/2019
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Provider Practice Location Address
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Address Line | 17651 1ST AVE S STE 101
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City | NORMANDY PARK
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State | WA
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Zip | 98148-2715
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Country | US
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Telephone | 206-241-3836
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Fax | 206-241-3967
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Provider Business Mailing Address
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Address Line | 17651 1ST AVE S STE 101
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City | NORMANDY PARK
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State | WA
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Zip | 98148-2715
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Country | US
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Telephone | 206-241-3836
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Fax | 206-241-3967
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. NICOLE LESHAW
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Credential | DC
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Telephone | 206-241-3836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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