Provider Demographics
NPI:1528564242
Name:LEONHARD, VANESSA DAWN (DO)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:DAWN
Last Name:LEONHARD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE, 7TH FLOOR CENTER TOWER ROOM 73.1
Mailing Address - Street 2:MAIL STOP #359796
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:623-251-9830
Mailing Address - Fax:
Practice Address - Street 1:325 9TH AVE, 7TH FLOOR CENTER TOWER ROOM 73.1
Practice Address - Street 2:MAIL STOP #359796
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:623-251-9830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program