MEDICARE: MRS. LESLIE A. ESTEP MD

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	MD00032199	WA
2	207Q00000X	Family Medicine Physician	MD0032199	WA
3	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	MD00032199	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	014683	OTHER	WA	L&I

General Provider Information

NPI Number	:	1457354896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LESLIE A. ESTEP MD

Provider Business Mailing Address
First Line	:	1400 E. KINCAID STREET
Second Line	:	ATTN: CREDENTIALING
City	:	MOUNT VERNON
State	:	WA
Zip	:	98274-4127
Country	:	US
Telephone Number	:	360-428-2500
Fax Number	:	360-428-6485

Provider Business Practice Location Address
First Line	:	227 FREEWAY DRIVE
Second Line	:	SUITE A
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273
Country	:	US
Telephone Number	:	360-814-5550
Fax Number	:	360-814-5591

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	03/22/2016

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