Provider Demographics
NPI:1366687733
Name:WEISS, LEONDRA T (MN, RN, C-EFM)
Entity Type:Individual
Prefix:MRS
First Name:LEONDRA
Middle Name:T
Last Name:WEISS
Suffix:
Gender:F
Credentials:MN, RN, C-EFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVENUE
Mailing Address - Street 2:MAILBOX 359854
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2499
Mailing Address - Country:US
Mailing Address - Phone:206-744-3869
Mailing Address - Fax:206-744-6333
Practice Address - Street 1:325 9TH AVE # 359854
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-3869
Practice Address - Fax:206-744-6333
Is Sole Proprietor?:No
Enumeration Date:2008-12-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00110874163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WARN00110874Medicaid