Michael Carlson Leisle, MD
Military Health Care Provider in Tacoma, WA. Individual provider (NPI-1).
NPI number1831904036
StatusActive
Last updated in NPPESFeb 13, 2025
Details
- NPI
- 1831904036
- Entity type
- Individual (NPI-1)
- Name
- Michael Carlson Leisle
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 13, 2025
- Certification date
- Feb 12, 2025
- Last updated
- Feb 13, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171000000X | Military Health Care Provider | – | – | Yes |
Practice location
9040 Jackson AveTacoma, WA 98431-0001
Phone 253-968-3105
Mailing address
9040 Jackson AveTacoma, WA 98431-0001
Phone 253-968-3105
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 147 Military Health Care Provider providers in Tacoma · All 15,721 providers in Tacoma
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