Provider Demographics
NPI:1255870788
Name:SLEIGHT, ALEXIS (LMP)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:SLEIGHT
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 N TACOMA AVE
Mailing Address - Street 2:B
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-2608
Mailing Address - Country:US
Mailing Address - Phone:541-915-2744
Mailing Address - Fax:
Practice Address - Street 1:3819 6TH AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-4903
Practice Address - Country:US
Practice Address - Phone:253-844-4137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-16
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60729537225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist