Healthcare Provider Details

I. General information

NPI: 1255608667
Provider Name (Legal Business Name): ZOE A LEONARD MSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2011
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 113TH AVE SE
LAKE STEVENS WA
98258-9472
US

IV. Provider business mailing address

1325 113TH AVE SE
LAKE STEVENS WA
98258-9472
US

V. Phone/Fax

Practice location:
  • Phone: 480-376-3319
  • Fax:
Mailing address:
  • Phone: 480-376-3319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60258671
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: