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General NPI Number Information
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NPI Number | 1750836110
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Entity Type | Individual
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Provider Name | LEANN SPOKUS MSW, MHP, CMHS
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Gender | Female
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Dates
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Enumeration Date | 08/15/2016
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Last Update Date | 09/19/2019
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Provider Practice Location Address
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Address Line | 11000 LAKE CITY WAY NE SUITE 2
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City | SEATTLE
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State | WA
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Zip | 98125-6748
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Country | US
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Telephone | 206-619-5451
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Fax |
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Provider Business Mailing Address
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Address Line | 14307 15TH AVE NE
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City | SHORELINE
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State | WA
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Zip | 98155
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Country | US
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Telephone |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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