| Doctor Name: | LEAH ADELA GRANT |
| NPI Number: | 1144470865 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | AP60040461 |
| Business Practice Address: | 1025 153rd St Se Ste 200 Mill Creek, WA - 980124051 |
| Business Phone Number: | 4253384000 |
| Business Fax Number: | 4257456158 |
| Mailing Address: | 1025 153rd St Se Ste 200, MILL CREEK |
| State: | WA |
| Postal Code: | 980124051 |
| Phone Number: | 4253384000 |
| Fax Number: | 4257456158 |
| NPI Enumeration Date: | 09/30/2008 |
| NPI Last Update Date: | 04/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP60040461 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |