Provider Demographics
NPI:1124837091
Name:SYKES, MEREDITH LEIGH (LE)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:LEIGH
Last Name:SYKES
Suffix:
Gender:
Credentials:LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 SW KING AVE STE 10
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1107
Mailing Address - Country:US
Mailing Address - Phone:919-971-0969
Mailing Address - Fax:
Practice Address - Street 1:1012 SW KING AVE STE 10
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1107
Practice Address - Country:US
Practice Address - Phone:919-971-0969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-04
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORBAP-E-10244662156F00000X, 246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other
No156F00000XEye and Vision Services ProvidersTechnician/Technologist