Healthcare Provider Details

I. General information

NPI: 1619097110
Provider Name (Legal Business Name): LEAH R SNARE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 COLBY AVE
EVERETT WA
98201-2916
US

IV. Provider business mailing address

2510 COLBY AVE
EVERETT WA
98201-2916
US

V. Phone/Fax

Practice location:
  • Phone: 425-258-3331
  • Fax: 425-258-9648
Mailing address:
  • Phone: 425-258-3331
  • Fax: 425-258-9648

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6499
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: