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Leilani Ortega

New
IN-004125 · DOB 1978-11-04
Date Created
2026-04-13
Assigned Staff
Priya Nair
ProviderOne ID
P1-882341
MedicAid Eligibility
Verified
WLP Status
Verified
Service County
Not provided
Service City
Not provided

Program Health & Risk Information

Housing

Diagnosis

Not recorded

Health Factors

Not recorded

Risk Factors

Not recorded

Employment

Diagnosis

Not recorded

Health Factors

Not recorded

Risk Factors

Not recorded

Recorded during intake from the client's initial assessment.

Treatment Status

Unknown / Not Reported

Unknown / Not Reported

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Current Situation Duration

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Enter the number of days based on the client's current situation.

Client Information

First Name
Leilani
Last Name
Ortega
Date of Birth
1978-11-04
Phone Number
(253) 555-0119
Center
Washington State
Program
HousingEmployment

Staff Assignment

Assigned Staff
Priya Nair
Date Assigned
2026-04-13

Intake Status History

1 transitions · most recent first
StatusChanged ByDate / Time
NewSystem2026-04-13 09:00

Authorization Upload

System-generated from ProviderOne batch imports
Not UploadedRead-only · updated automatically after each successful import
No matching authorization has been uploaded for this client.

Document Readiness

Required before moving from Draft to New
Authorization
Uploaded
Consent Form
Not Uploaded
Pre-Qualify Eligibility Questionnaire
Uploaded