Provider Demographics
NPI:1174132716
Name:MORROW, LESLEY PAULETTE (RDH)
Entity type:Individual
Prefix:
First Name:LESLEY
Middle Name:PAULETTE
Last Name:MORROW
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:OKANOGAN
Mailing Address - State:WA
Mailing Address - Zip Code:98840-9679
Mailing Address - Country:US
Mailing Address - Phone:509-422-5700
Mailing Address - Fax:
Practice Address - Street 1:101 6TH ST
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:WA
Practice Address - Zip Code:98812-3404
Practice Address - Country:US
Practice Address - Phone:509-689-3789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2020-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00006766124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist