| Doctor Name: | MR. LEON DOUGLAS EAGLE TAIL |
| NPI Number: | 1780878694 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSW, CDP |
| License Number: | RC00025859 |
| Business Practice Address: | 224 N Willow Rd Spokane Valley, WA - 992066812 |
| Business Phone Number: | 5099273837 |
| Business Fax Number: | |
| Mailing Address: | 224 N Willow Rd, SPOKANE VALLEY |
| State: | WA |
| Postal Code: | 992066812 |
| Phone Number: | 5099273837 |
| Fax Number: | |
| NPI Enumeration Date: | 09/04/2007 |
| NPI Last Update Date: | 09/04/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | RC00025859 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |