Provider Demographics
NPI:1578151577
Name:LESLIE, HANNAH MARIAH
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:MARIAH
Last Name:LESLIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 NE 44TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-2228
Mailing Address - Country:US
Mailing Address - Phone:425-941-5425
Mailing Address - Fax:
Practice Address - Street 1:908 NE 44TH AVE APT 4
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2228
Practice Address - Country:US
Practice Address - Phone:425-941-5425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTHW000104011374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula