Basic Information
| Provider Information | |||||||||
| NPI: | 1659544526 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SILVAS | ||||||||
| FirstName: | LEAH | ||||||||
| MiddleName: | RENEE | ||||||||
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| Credential: | CDP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1026 E 1ST ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | PORT ANGELES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983624020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604524432 | ||||||||
| FaxNumber: | 3604524599 | ||||||||
| Practice Location | |||||||||
| Address1: | 1026 E 1ST ST | ||||||||
| Address2: | SUITE 2 | ||||||||
| City: | PORT ANGELES | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983624020 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3604524432 | ||||||||
| FaxNumber: | 3604524599 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/10/2008 | ||||||||
| LastUpdateDate: | 04/10/2008 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | CP00005550 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.