MEDICARE: ALISHEA LEUENBERGER LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WM1400X	Nurse Massage Therapist (NMT)	MA60752311	WA

General Provider Information

NPI Number	:	1467987966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISHEA LEUENBERGER LMT

Provider Business Mailing Address
First Line	:	525 N BOWDOIN PL APT 102
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-7744
Country	:	US
Telephone Number	:	917-822-1577
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 N BOWDOIN PL APT 102
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-7744
Country	:	US
Telephone Number	:	917-822-1577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2017
Last Update Date	:	04/22/2017

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