| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LEAH I. BLACK | 1225195670 | 2024-07-05 |
Leah I. Black is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1225195670. Registration indicates Leah I. Black is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse: Hospice, ) (Registered Nurse Hospice, Nursing Service Providers) (Registered Nurse, )
| Entity Type | Individual |
| Provider Name | Leah I. Black RN |
| Practice Office Address | 1313 BROADWAY STE 200 TACOMA, WA US |
| Practice Office Telephone | 2533016490 |
| Practice Office Fax | 2533016531 |
| Mailing Address | PO BOX 5299 TACOMA, WA 984150299 US |
| Business Telephone | 2533016490 |
| Business Fax | 2533016531 |
| Code | Practice | License No State |
|---|---|---|
| 163WH1000X PRIMARY | Nursing Service Providers Registered Nurse Registered Nurse: Hospice Registered Nurse Hospice Nursing Service Providers Registered Nurse | RN00120454
WA |
| 9641473 | MEDICAID | WA |