Provider Demographics
NPI:1710604004
Name:METTLER AULD, LESLEY C (FNS, CPT)
Entity Type:Individual
Prefix:
First Name:LESLEY
Middle Name:C
Last Name:METTLER AULD
Suffix:
Gender:F
Credentials:FNS, CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7411 KEEN WAY N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4832
Mailing Address - Country:US
Mailing Address - Phone:206-786-7236
Mailing Address - Fax:
Practice Address - Street 1:7411 KEEN WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-4832
Practice Address - Country:US
Practice Address - Phone:206-786-7236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer