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NPI Code Detail

MEDICARE: DR. LESLIE MONARCH LESLIE MONARCH LAC

MEDICARE: DR. LESLIE MONARCH LESLIE MONARCH LAC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist000340OR

General Provider Information

NPI Number : 1215215660
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LESLIE MONARCH LESLIE MONARCH LAC
Provider Business Mailing Address
First Line : PO BOX 7979
Second Line :
City : SALEM
State : OR
Zip : 97303-0212
Country : US
Telephone Number : 503-702-3206
Fax Number :
Provider Business Practice Location Address
First Line : 4400 SALEM DALLAS HWY NW
Second Line :
City : SALEM
State : OR
Zip : 97304-3338
Country : US
Telephone Number : 503-208-6425
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2011
Last Update Date : 07/22/2024

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