Individual
MEGAN LEAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 501-3500
Mailing address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 501-3500
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN60818606
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
WA
Other
Enumeration date
04/17/2025
Last updated
04/17/2025
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