1891300562 NPI number — MR. JONATHAN DAVID LEONG MA, LMHC

Table of content: MR. JONATHAN DAVID LEONG MA, LMHC (NPI 1891300562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891300562 NPI number — MR. JONATHAN DAVID LEONG MA, LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEONG
Provider First Name:
JONATHAN
Provider Middle Name:
DAVID
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MA, LMHC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LEONG
Provider Other First Name:
JON
Provider Other Middle Name:
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1891300562
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2830 228TH AVE SE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAMMAMISH
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98075-9300
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-780-5294
Provider Business Mailing Address Fax Number:
425-677-7753

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 LAKE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SNOHOMISH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98290-1026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-780-5294
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/10/2020

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: 101YM0800X , with the licence number:  MHC1102 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: LH61539130 , 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)





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