Leak, Carol Annette
Leak, Carol Annette is an individual health care provider with primary practice located at 6450 Southcenter Blvd , Tukwila WA 98188-2552. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Leak, Carol Annette can be contacted via phone (206) 466-5012.Contact Information
Primary practice address
6450 Southcenter Blvd
Tukwila WA 98188-2552
Phone: (206) 466-5012
Fax: (206) 453-4404
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | CP61215945 | Washington |
Profile Details
| NPI number | 1780224360 |
|---|---|
| LBN Legal business name | Leak, Carol Annette |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 10th, 2020 |
| Last updated | Oct 31st, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780224360 | NPPES |
| North Carolina | MEDICAID | 2382777448 |
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