Healthcare Provider Details

I. General information

NPI: 1255408696
Provider Name (Legal Business Name): ALAN D. LEONG PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

101 W 8TH AVE P.O. BOX 2555
SPOKANE WA
99204-2307
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-3242
  • Fax: 509-474-4491
Mailing address:
  • Phone: 509-474-3242
  • Fax: 509-474-4491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH00041230
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: