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General NPI Number Information
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NPI Number | 1003542408
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Entity Type | Individual
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Provider Name | LEONARD COVARRUBIAS JR. MC
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Gender | Male
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 6351 W RIO GRANDE AVE
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City | KENNEWICK
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State | WA
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Zip | 99336-7634
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Country | US
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Telephone | 509-543-9280
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | TOPPENISH
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State | WA
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Zip | 98948-0190
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Country | US
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Telephone | 509-543-9280
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61670196
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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