Most Relevant Information
Provider Data
| NPI Number: | 1003539438 |
| Provider Name: | LEIGHSA M GERVAIS MED, BSN, RN, NCSN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WS0200X |
| Specialty: | Registered Nurse |
| License Number: | RN00127768 |
Most Important Dates
| Enumeration Date: | 09/21/2022 |
| Last Updated: | 09/21/2022 |
Provider Practice Location
1616 W OCTAVE ST
PASCO
WA
993014075
Practice Location Phone/Fax
| Phone: | 5095436792 |
| Fax: | 5095462698 |
Provider Mailing Location
1616 W OCTAVE ST
PASCO
WA
993014075
Provider Mailing Phone/Fax
| Phone: | 5095436792 |
| Fax: | 5095462698 |