| |
2800 E Madison St Ste 201 Seattle WA 98112-4865 | |
(206) 717-5622 | |
(949) 561-4815 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2800 E Madison St Ste 201, Seattle, Washington |
Authorized Official Name and Position | Leslie Casias (OWNER/PROVIDER) |
Authorized Official Contact | 2067175622 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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2800 E Madison St Ste 201 Seattle WA 98112-4865 Ph: (206) 717-5622 | 2800 E Madison St Ste 201 Seattle WA 98112-4865 Ph: (206) 717-5622 |
NPI Number | 1750019147 |
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Provider Enumeration Date | 08/12/2022 |
Last Update Date | 07/26/2023 |
Medicare PECOS PAC ID | 2264802354 |
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Medicare Enrollment ID | O20230106000453 |
Identifier | Type | State | Issuer |
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1750019147 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Provider Name | Leslie S Casias |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1699085308 PECOS PAC ID: 5698918951 Enrollment ID: I20150529002664 |
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