Doctor Name: | LEANNE M GRAVES |
NPI Number: | 1215098165 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMP |
License Number: | MA00011334 |
Business Practice Address: | 11903 Ne 128th Sreet Suite B Kirkland, WA - 98034 |
Business Phone Number: | 4252983363 |
Business Fax Number: | 4258251406 |
Mailing Address: | Po Box 2454, WOODINVILLE |
State: | WA |
Postal Code: | 98072 |
Phone Number: | 4252983363 |
Fax Number: | |
NPI Enumeration Date: | 12/13/2006 |
NPI Last Update Date: | 04/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA00011334 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |