Provider Demographics
NPI:1942403506
Name:LECKENBY, PATRICIA S (ARNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:S
Last Name:LECKENBY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:EDITH
Other - Last Name:SUROWIECKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1120 8TH AVE
Mailing Address - Street 2:#502
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2792
Mailing Address - Country:US
Mailing Address - Phone:206-749-0098
Mailing Address - Fax:
Practice Address - Street 1:1120 8TH AVE
Practice Address - Street 2:#502
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2792
Practice Address - Country:US
Practice Address - Phone:206-749-0098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001796163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent