Individual
SHANNON M LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1700 13TH ST, EVERETT, WA 98201-1689
(425) 404-5345
(425) 404-5330
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60247426
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP60247426
WSL
WA
Enumeration date
09/29/2011
Last updated
11/12/2015
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