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General NPI Number Information
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NPI Number | 1841567674
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Entity Type | Individual
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Provider Name | CARLYN SARA LEAHEY PA
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Gender | Female
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Dates
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Enumeration Date | 11/22/2011
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Last Update Date | 10/20/2023
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Provider Practice Location Address
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Address Line | 1321 COLBY AVE
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City | EVERETT
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State | WA
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Zip | 98201
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Country | US
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Telephone | 425-261-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 1035 116TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98004-4604
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Country | US
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Telephone | 425-635-6731
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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 | 1099
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5055
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 5055
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 1099
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License Number State | AL
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Taxonomy #5
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA60711668
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License Number State | WA
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