Provider Demographics
NPI:1316349079
Name:SYLVAN, LESLEY
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:
Last Name:SYLVAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 5TH AVE N UNIT A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2934
Mailing Address - Country:US
Mailing Address - Phone:718-313-2117
Mailing Address - Fax:
Practice Address - Street 1:1617 5TH AVE N UNIT A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2934
Practice Address - Country:US
Practice Address - Phone:718-313-2117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist