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NPI Code Detail

MEDICARE: LESLIE F. GRAHAM LICSW

MEDICARE: LESLIE F. GRAHAM LICSW
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
1101Y00000XCounselorRC00015675WA
21041C0700XClinical Social WorkerLW00007570WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18902748OTHERWAL&I CRIME VICTIMS

General Provider Information

NPI Number : 1669577714
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESLIE F. GRAHAM LICSW
Provider Business Mailing Address
First Line : PO BOX 359750
Second Line :
City : SEATTLE
State : WA
Zip : 98195-9750
Country : US
Telephone Number : 206-520-5000
Fax Number :
Provider Business Practice Location Address
First Line : 23213 PACIFIC HWY S
Second Line :
City : KENT
State : WA
Zip : 98032-2721
Country : US
Telephone Number : 206-520-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 08/01/2023

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