Provider Demographics
NPI:1407153307
Name:SLEIGHT, JESSICA (LAC, MACOM, DIPLAC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:SLEIGHT
Suffix:
Gender:F
Credentials:LAC, MACOM, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 S SODA RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-9059
Mailing Address - Country:US
Mailing Address - Phone:509-999-5137
Mailing Address - Fax:
Practice Address - Street 1:915 S PERRY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3462
Practice Address - Country:US
Practice Address - Phone:509-999-5137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-12
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8559081-1201171100000X
WAAC 60522136171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist