Provider Demographics
NPI:1588135784
Name:OLSZEWSKI, LEIGH ANNE (MS)
Entity type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANNE
Last Name:OLSZEWSKI
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LEIGH
Other - Middle Name:ANNE
Other - Last Name:STEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4347 CRESTONE ST NE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98516-1341
Mailing Address - Country:US
Mailing Address - Phone:715-966-5931
Mailing Address - Fax:
Practice Address - Street 1:413 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5133
Practice Address - Country:US
Practice Address - Phone:360-493-7060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60747848101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACG60747848OtherWASHINGTON STATE DEPARTMENT OF HEALTH