Provider Demographics
NPI:1053833616
Name:PALMER, LESLIE (RN, BSN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:PALMER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6420 159TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-8710
Mailing Address - Country:US
Mailing Address - Phone:509-481-7661
Mailing Address - Fax:
Practice Address - Street 1:6420 159TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-8710
Practice Address - Country:US
Practice Address - Phone:509-481-7661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60275496163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse