Provider Demographics
NPI:1821154980
Name:LEICHMAN, SUZANNE SEXTON (MA, ARNP,BC)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:SEXTON
Last Name:LEICHMAN
Suffix:
Gender:F
Credentials:MA, ARNP,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4423 POINT FOSDICK DR NW
Mailing Address - Street 2:SUITE 214
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1797
Mailing Address - Country:US
Mailing Address - Phone:253-851-4404
Mailing Address - Fax:253-851-4507
Practice Address - Street 1:4423 POINT FOSDICK DR NW
Practice Address - Street 2:SUITE 214
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1797
Practice Address - Country:US
Practice Address - Phone:253-851-4404
Practice Address - Fax:253-851-4507
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30002009163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult