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Leisa S Garrett

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1201 Pacific Ave Ste 600, Tacoma, WA 98402

PECOS Enrollment

This provider is enrolled in PECOS as LEISA GARRETT.

Based on the most recent information from CMS, provider Leisa S Garrett is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1104193242
Provider Type
Individual
Full Name
Garrett, Leisa S
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/17/2011
Last Updated
5/22/2019

Contact Information

Practice Location

1201 Pacific Ave Ste 600, Tacoma, WA 98402

(253) 203-3131

(253) 397-3530

Mailing Location

1201 Pacific Ave Ste 600, Tacoma, WA 98402-4384

(253) 203-3131

(253) 397-3530

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA10003091 Washington
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA10003091 Washington

Provider Identifiers

ID	Description	Issuer
ID 0310585	Description Other	Issuer STATE L&I Washington

Leisa S Garrett

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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