Provider Demographics
NPI:1942366067
Name:RAZNICK, LESLIE ELLEN (LAC)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ELLEN
Last Name:RAZNICK
Suffix:
Gender:F
Credentials:LAC
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 15705
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-0705
Mailing Address - Country:US
Mailing Address - Phone:206-349-8686
Mailing Address - Fax:
Practice Address - Street 1:3210 SMOKEY POINT DR
Practice Address - Street 2:SUITE #100
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-7805
Practice Address - Country:US
Practice Address - Phone:206-349-8686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000741171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist