MEDICARE: SARAH ELLEN LESKO M.D.

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
1	207Q00000X	Family Medicine Physician	MD00043006	WA

General Provider Information

NPI Number	:	1447220439
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELLEN LESKO M.D.

Provider Business Mailing Address
First Line	:	2101 E YESLER WAY
Second Line	:	SUITE 150
City	:	SEATTLE
State	:	WA
Zip	:	98122-5959
Country	:	US
Telephone Number	:	206-299-1900
Fax Number	:

Provider Business Practice Location Address
First Line	:	2101 E YESLER WAY
Second Line	:	SUITE 150
City	:	SEATTLE
State	:	WA
Zip	:	98122-5959
Country	:	US
Telephone Number	:	206-299-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	10/11/2011

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