Provider Demographics
NPI:1275389546
Name:THOMAS, LESLIE P (RN)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:P
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:469 HILLTOP AVE APT 21
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4155
Mailing Address - Country:US
Mailing Address - Phone:253-227-4460
Mailing Address - Fax:
Practice Address - Street 1:469 HILLTOP AVE APT 21
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4155
Practice Address - Country:US
Practice Address - Phone:253-227-4460
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-27
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201902631RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse