Provider Demographics
NPI:1003681230
Name:GLAVAN, LEAH SUZANNE (BSN RN CIS)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:SUZANNE
Last Name:GLAVAN
Suffix:
Gender:F
Credentials:BSN RN CIS
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Mailing Address - Street 1:1801 LIND AVE SW
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3368
Mailing Address - Country:US
Mailing Address - Phone:855-537-4470
Mailing Address - Fax:866-315-0607
Practice Address - Street 1:4101 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4607
Practice Address - Country:US
Practice Address - Phone:310-540-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA481004364SI0800X, 163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SI0800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistInformatics
No163WX0800XNursing Service ProvidersRegistered NurseOrthopedic