Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD00032199 | WA |
N | 207Q00000X | Family Doctor | MD0032199 | WA |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | MD00032199 | WA |
NPI | 1457354896 |
---|---|
Provider Name | Mrs. Leslie A. Estep |
First Address | Mount Vernon, WA 98274-4127 |
Second Address | Mount Vernon, WA 98273 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2005 |
Last Update Date | 22/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014683 | L&I (01) | WA |
8185985 | (05) | WA |
G19084 | (02) |