Provider Demographics
NPI:1689905986
Name:LEJA, ANGELA (PSY D)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:LEJA
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 1ST AVE S
Mailing Address - Street 2:SUITE 323
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3441
Mailing Address - Country:US
Mailing Address - Phone:206-467-6562
Mailing Address - Fax:
Practice Address - Street 1:216 1ST AVE S
Practice Address - Street 2:SUITE 323
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3441
Practice Address - Country:US
Practice Address - Phone:206-467-6562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1651103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling