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General NPI Number Information
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NPI Number | 1457748915
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Entity Type | Individual
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Provider Name | JENNIFER LEICHTMAN OTR/L
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Gender | Female
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 1981 NE COLUMBIA RD
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City | SEATTLE
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State | WA
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Zip | 98195-7869
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Country | US
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Telephone | 206-734-5219
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Fax |
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Provider Business Mailing Address
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Address Line | 4118 42ND AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-5125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number | OT60436213
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License Number State | WA
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