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General NPI Number Information
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NPI Number | 1487357844
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Entity Type | Individual
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Provider Name | LEAH ENGEBRETSON ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/24/2023
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Last Update Date | 03/24/2023
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Provider Practice Location Address
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Address Line | 971 11TH AVE
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City | LONGVIEW
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State | WA
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Zip | 98632-2503
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Country | US
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Telephone | 360-577-1771
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Fax |
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Provider Business Mailing Address
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Address Line | 6325 SW BROAD OAK DR
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City | BEAVERTON
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State | OR
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Zip | 97007-4625
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Country | US
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Telephone | 406-871-4503
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP61415835
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License Number State | WA
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