Healthcare Provider Details

I. General information

NPI: 1255086484
Provider Name (Legal Business Name): REBECCA A. LEBLANC DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 8TH AVE NE STE 340
ISSAQUAH WA
98029-5449
US

IV. Provider business mailing address

522 AMHERST ST STE 22
NASHUA NH
03063-1019
US

V. Phone/Fax

Practice location:
  • Phone: 425-313-3055
  • Fax: 425-313-3051
Mailing address:
  • Phone: 603-880-0448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4856
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT61643350
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: