Provider Demographics
NPI:1265086656
Name:CHUN HAJARIZADEH, LESLIE (MSW)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:
Last Name:CHUN HAJARIZADEH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 53RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-2931
Mailing Address - Country:US
Mailing Address - Phone:503-805-8746
Mailing Address - Fax:
Practice Address - Street 1:33400 9TH AVE S STE 100
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-2607
Practice Address - Country:US
Practice Address - Phone:206-567-7267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC.60894125104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker