| Doctor Name: | MRS. LEANNE MAYLENE HAKE |
| NPI Number: | 1003256231 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADCI |
| License Number: | RW5154 |
| Business Practice Address: | 400 Virginia Ave North Bend, OR - 974593477 |
| Business Phone Number: | 5414920235 |
| Business Fax Number: | 5417519985 |
| Mailing Address: | 400 Virginia Ave, NORTH BEND |
| State: | OR |
| Postal Code: | 974593477 |
| Phone Number: | 5414920235 |
| Fax Number: | 5417519985 |
| NPI Enumeration Date: | 07/02/2013 |
| NPI Last Update Date: | 01/26/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | RW5154 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |