Healthcare Provider Details

I. General information

NPI: 1255967675
Provider Name (Legal Business Name): VERONICA LEUNG MO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2020
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 3RD AVE STE 400
SEATTLE WA
98101-3207
US

IV. Provider business mailing address

1111 3RD AVE STE 400
SEATTLE WA
98101-3207
US

V. Phone/Fax

Practice location:
  • Phone: 206-515-7953
  • Fax: 206-521-8834
Mailing address:
  • Phone: 206-515-7953
  • Fax: 206-521-8834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC60294914
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: