Provider Demographics
NPI:1386679173
Name:GOLEMBIOWSKI, LEANNE (ARNP)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:GOLEMBIOWSKI
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21612 26TH ST E
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-5644
Mailing Address - Country:US
Mailing Address - Phone:360-790-7752
Mailing Address - Fax:
Practice Address - Street 1:5314 176TH ST E STE A
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98446-7507
Practice Address - Country:US
Practice Address - Phone:253-875-7630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00141521163W00000X
WAAP1332924363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse