Provider Demographics
NPI:1285000216
Name:LETA AYRES DELEGATION SERVICES
Entity Type:Organization
Organization Name:LETA AYRES DELEGATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LETA
Authorized Official - Middle Name:
Authorized Official - Last Name:AYRES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:360-600-1625
Mailing Address - Street 1:7410 SE EVERGREEN HWY
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664
Mailing Address - Country:US
Mailing Address - Phone:360-597-3835
Mailing Address - Fax:360-597-4654
Practice Address - Street 1:7410 SE EVERGREEN HWY
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664
Practice Address - Country:US
Practice Address - Phone:360-597-3835
Practice Address - Fax:360-597-4654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-13
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00123177163W00000X, 364SH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No364SH0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistHome HealthGroup - Multi-Specialty