Individual
MRS. LEANNE BRUNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
410 E. NORTH BEND WAY, NORTH BEND, WA 98045
(425) 888-5060
Mailing address
23842 SE 45TH ST, ISSAQUAH, WA 98029-6526
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA60116017
WA
Other
Enumeration date
11/25/2009
Last updated
11/25/2009
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