Individual
MICHAEL P LEACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AAC, CPC
Contact information
Practice address
910 16TH AVE STE 120, LONGVIEW, WA 98632-2374
(360) 200-5419
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
61294471
WA
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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