Provider Demographics
NPI:1922388552
Name:LESH, TINA RUTH (BS)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:RUTH
Last Name:LESH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8007 114TH LN SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-8553
Mailing Address - Country:US
Mailing Address - Phone:360-570-2027
Mailing Address - Fax:
Practice Address - Street 1:220 S 3RD PL
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2405
Practice Address - Country:US
Practice Address - Phone:425-228-0074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-26
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist