Provider Demographics
NPI:1417049008
Name:LAMBERT, LEAH (CNM)
Entity Type:Individual
Prefix:
First Name:LEAH
Middle Name:
Last Name:LAMBERT
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-366-2983
Mailing Address - Fax:
Practice Address - Street 1:916 PACIFIC AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201
Practice Address - Country:US
Practice Address - Phone:425-303-6500
Practice Address - Fax:425-303-6550
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00086152163WW0101X
WAAP30003625363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9615766Medicaid
S73069Medicare UPIN
8801816Medicare ID - Type UnspecifiedRAINIERPARK CLINIC
WA9615766Medicaid
S73069Medicare UPIN
8801410Medicare ID - Type Unspecified45TH ST. CLINIC
8801818Medicare ID - Type UnspecifiedHIGH POINT CLINIC
8801408Medicare ID - Type UnspecifiedRAINIER BEACH