Provider Demographics
NPI:1760172027
Name:LEYVA VERA, CHRISTOPHER ALEXIS
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ALEXIS
Last Name:LEYVA VERA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 359930
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-9930
Mailing Address - Country:US
Mailing Address - Phone:206-744-2910
Mailing Address - Fax:206-744-4151
Practice Address - Street 1:NINTH AND JEFFERSON BUILDING
Practice Address - Street 2:325 9TH AVENUE
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:204-744-2910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC613755681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical