Most Relevant Information
Provider Data
| NPI Number: | 1003077025 |
| Provider Name: | LESLIE ANN DERVAN MD |
| Entity Type: | Individual |
| Taxonomy Code: | 2080P0203X |
| Specialty: | Pediatrics |
| License Number: | 60205855 |
Most Important Dates
| Enumeration Date: | 06/23/2008 |
| Last Updated: | 07/24/2013 |
Provider Practice Location
4800 SAND POINT WAY NE
MB.10.620
SEATTLE
WA
981053901
Practice Location Phone/Fax
| Phone: | 2069870293 |
| Fax: |
Provider Mailing Location
4800 SAND POINT WAY NE
MB.10.620
SEATTLE
WA
981053901
Provider Mailing Phone/Fax
| Phone: | 2069870293 |
| Fax: |