Provider Demographics
NPI:1922105683
Name:VAUGHAN, LESLEY FIONA (OTR/L)
Entity Type:Individual
Prefix:MS
First Name:LESLEY
Middle Name:FIONA
Last Name:VAUGHAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:FIONA
Other - Middle Name:
Other - Last Name:VAUGHAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OTR/L
Mailing Address - Street 1:100 DENNIS ST SW
Mailing Address - Street 2:STE B
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-6523
Mailing Address - Country:US
Mailing Address - Phone:360-338-0181
Mailing Address - Fax:360-491-1654
Practice Address - Street 1:4740 AVERY LN SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5603
Practice Address - Country:US
Practice Address - Phone:360-491-1815
Practice Address - Fax:360-491-1654
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1073193225XH1200X
WAOT00004020225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA214390OtherDEPT OF LABOR & INDUSTRY
WA8942830OtherCRIME VICTIMS