Provider Demographics
NPI:1952444770
Name:COHN, LESLIE A (ARNP)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:A
Last Name:COHN
Suffix:
Gender:F
Credentials:ARNP
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 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-258-3900
Mailing Address - Fax:
Practice Address - Street 1:4027 HOYT AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4972
Practice Address - Country:US
Practice Address - Phone:425-339-5468
Practice Address - Fax:425-259-1172
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00067685363L00000X
WAAP30003215363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1023077Medicaid
WA9609975Medicaid
WA9609975Medicaid
WAGAB14470Medicare PIN
WAP02449Medicare UPIN
WAGAB14473Medicare PIN
WAGAB14471Medicare PIN
WAG8944788Medicare UPIN
WA1023077Medicaid