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General NPI Number Information
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NPI Number | 1619376530
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Entity Type | Individual
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Provider Name | LEILANI DE JONG ARNP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2014
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 4030 LAKE WASHINGTON BLVD NE STE 201
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City | KIRKLAND
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State | WA
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Zip | 98033-7870
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Country | US
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Telephone | 425-559-1482
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Fax | 844-729-1751
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Provider Business Mailing Address
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Address Line | 4030 LAKE WASHINGTON BLVD NE STE 201
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City | KIRKLAND
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State | WA
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Zip | 98033-7870
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Country | US
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Telephone | 425-559-1482
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Fax | 844-729-1751
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP60491301
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License Number State | WA
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