Individual
LEAYN N VANDEVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055
(360) 418-6001
Mailing address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055
(360) 418-6001
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
2021036667
MO
390200000X
Student in an Organized Health Care Education/Training Program
RN60612445
WA
Other
Enumeration date
12/27/2019
Last updated
09/10/2021
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