Healthcare Provider Details

I. General information

NPI: 1023932647
Provider Name (Legal Business Name): HAVEN WOMENS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 6TH ST
BELLINGHAM WA
98225-7057
US

IV. Provider business mailing address

1401 6TH ST
BELLINGHAM WA
98225-7057
US

V. Phone/Fax

Practice location:
  • Phone: 360-766-0693
  • Fax:
Mailing address:
  • Phone: 360-766-0693
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LEILANI MARIANNE ACOBA LEONG
Title or Position: PROVIDER/OWNER
Credential: ARNP
Phone: 360-766-0693