Individual
LEANN G BACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
601 W 5TH AVE, SUITE 400, SPOKANE, WA 99204-2715
(509) 344-2663
(509) 624-9179
Mailing address
1414N VERCLER RD 4, SPOKANE VALLEY, WA 99216-1092
(509) 924-4681
(509) 922-7634
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004060
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6016BA
ASURIS NW HEALTH
—
01
—
806048900
MEDICAID OTHER
WA
05
—
8329666
—
WA
Enumeration date
08/11/2005
Last updated
09/21/2015
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