Provider Demographics
NPI:1124171236
Name:ALFANO, LEAH
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:ALFANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TL SURGICAL
Other - Middle Name:
Other - Last Name:ASSISTANT PLLC
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:12975 SW BEAVERDAM RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-2126
Mailing Address - Country:US
Mailing Address - Phone:360-601-2984
Mailing Address - Fax:360-546-2473
Practice Address - Street 1:12975 SW BEAVERDAM RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-2126
Practice Address - Country:US
Practice Address - Phone:360-601-2984
Practice Address - Fax:360-546-2473
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2008-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist