1780604231 NPI number — KATHERINE J LEONE MN, ARNP

Table of content: KATHERINE J LEONE MN, ARNP (NPI 1780604231)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780604231 NPI number — KATHERINE J LEONE MN, ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEONE
Provider First Name:
KATHERINE
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MN, ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PEARCE
Provider Other First Name:
KATHY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MN, ARNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1780604231
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5096
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98227-5096
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-738-2200
Provider Business Mailing Address Fax Number:
360-752-5674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4545 CORDATA PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98226-7123
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-738-2200
Provider Business Practice Location Address Fax Number:
360-752-5674
Provider Enumeration Date:
07/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  AP30005390 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1780604231 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0261489 . This is a "L&I AND CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: NP313WA , issued by the state of ( AK ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0151PE . This is a "REGENCE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7203234 . This is a "AETNA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 806598400 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4300864 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".




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