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Individual

LEATHA N VAAGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
213 5TH ST NE, DEVILS LAKE, ND 58301-2425
(701) 662-2216
(701) 401-0104
Mailing address
213 5TH ST NE, DEVILS LAKE, ND 58301-2425
(701) 662-2216
(701) 401-0104

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
984
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
26709
BCBS
ND
01
26711
BCBS ND COL
ND
Enumeration date
05/22/2007
Last updated
09/12/2025
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