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General NPI Number Information
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NPI Number | 1043304363
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Entity Type | Individual
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Provider Name | LEANNE BRINK PA
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 330 S STILLAGUAMISH AVE
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City | ARLINGTON
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State | WA
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Zip | 98223-1642
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Country | US
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Telephone | 360-435-2133
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Fax | 360-435-1415
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Provider Business Mailing Address
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Address Line | PO BOX 1648
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City | EUGENE
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State | OR
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Zip | 97440-1648
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Country | US
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Telephone | 702-954-7819
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA10004914
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA10004914
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1219554
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License Number State | OR
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