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General NPI Number Information
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NPI Number | 1578129235
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Entity Type | Individual
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Provider Name | LEANN DE LUNA
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Gender | Female
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Dates
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Enumeration Date | 05/17/2019
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Last Update Date | 05/17/2019
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Provider Practice Location Address
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Address Line | 7416 212TH ST SW
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City | EDMONDS
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State | WA
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Zip | 98026-7609
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Country | US
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Telephone | 425-502-9945
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Fax |
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Provider Business Mailing Address
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Address Line | 18241 73RD AVE NE APT 202
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City | KENMORE
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State | WA
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Zip | 98028-2761
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Country | US
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Telephone | 805-705-1578
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN60835416
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License Number State | WA
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