Individual
GINA LEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19351 8TH AVE NE STE 141, POULSBO, WA 98370-7087
(360) 876-9430
Mailing address
21471 HOWARD AVE NE, KINGSTON, WA 98346-9104
(806) 567-5364
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61099384
WA
Other
Enumeration date
09/23/2021
Last updated
09/28/2021
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