Provider Demographics
NPI:1962546382
Name:RAWLINGS, LESLIE H
Entity type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:H
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:LESLIE
Other - Middle Name:H
Other - Last Name:RAWLINGS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:1001 BROADWAY
Mailing Address - Street 2:SUITE 315
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4397
Mailing Address - Country:US
Mailing Address - Phone:206-323-0905
Mailing Address - Fax:206-323-3687
Practice Address - Street 1:1001 BROADWAY
Practice Address - Street 2:SUITE 315
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4397
Practice Address - Country:US
Practice Address - Phone:206-323-0905
Practice Address - Fax:206-323-3687
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA551103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic