Individual
LEAH ANN BRUNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
2730 PACIFIC BLVD SE, ALBANY, OR 97321-5075
(541) 967-3888
(541) 926-2102
Mailing address
2730 PACIFIC BLVD SE, ALBANY, OR 97321-5075
(541) 967-3888
(541) 926-2102
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-14927
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174N00000X
PRIVATE INSURANCE
OR
05
—
174N00000X
—
OR
Enumeration date
10/12/2017
Last updated
10/12/2017
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