Healthcare Provider Details

I. General information

NPI: 1528438470
Provider Name (Legal Business Name): LEAH ANN BUEHLER B.S., CDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 04/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2610 WETMORE AVE
EVERETT WA
98201-2927
US

IV. Provider business mailing address

2610 WETMORE AVE
EVERETT WA
98201-2927
US

V. Phone/Fax

Practice location:
  • Phone: 425-257-2111
  • Fax:
Mailing address:
  • Phone: 425-257-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number60595436
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP60771585
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: