MEDICARE: MS. SUZANNE SEXTON LEICHMAN MA, ARNP,BC

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	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	AP30002009	WA

General Provider Information

NPI Number	:	1821154980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUZANNE SEXTON LEICHMAN MA, ARNP,BC

Provider Business Mailing Address
First Line	:	4423 POINT FOSDICK DR NW
Second Line	:	SUITE 214
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1797
Country	:	US
Telephone Number	:	253-851-4404
Fax Number	:	253-851-4507

Provider Business Practice Location Address
First Line	:	4423 POINT FOSDICK DR NW
Second Line	:	SUITE 214
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1797
Country	:	US
Telephone Number	:	253-851-4404
Fax Number	:	253-851-4507

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

Provider Enumeration Date	:	12/30/2006
Last Update Date	:	07/08/2007

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