Provider Demographics
NPI:1720552136
Name:TRAN, LEON Q (BAS, AAC)
Entity Type:Individual
Prefix:
First Name:LEON
Middle Name:Q
Last Name:TRAN
Suffix:
Gender:M
Credentials:BAS, AAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10303 MERIDIAN AVE N STE 204
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-9483
Mailing Address - Country:US
Mailing Address - Phone:206-420-7949
Mailing Address - Fax:
Practice Address - Street 1:10303 MERIDIAN AVE N STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9483
Practice Address - Country:US
Practice Address - Phone:206-420-7949
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator