Healthcare Provider Details

I. General information

NPI: 1699576595
Provider Name (Legal Business Name): LEILANI M NORMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 E IVY ST
BELLINGHAM WA
98225-5531
US

IV. Provider business mailing address

412 E IVY ST
BELLINGHAM WA
98225-5531
US

V. Phone/Fax

Practice location:
  • Phone: 206-920-2158
  • Fax:
Mailing address:
  • Phone: 206-920-2158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: