Provider Demographics
NPI:1275398711
Name:FOSTER, LEAH (DC)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:FOSTER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 NE 72ND AVE APT 82
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98661-3697
Mailing Address - Country:US
Mailing Address - Phone:503-360-8612
Mailing Address - Fax:
Practice Address - Street 1:1908 NW 1ST WAY STE 113
Practice Address - Street 2:
Practice Address - City:BATTLE GROUND
Practice Address - State:WA
Practice Address - Zip Code:98604-4560
Practice Address - Country:US
Practice Address - Phone:360-687-3181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH61461443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor