Provider Demographics
NPI:1548617475
Name:PACE, LEANNE (MA)
Entity Type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:
Last Name:PACE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N MERIDIAN ST
Mailing Address - Street 2:#6
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-1144
Mailing Address - Country:US
Mailing Address - Phone:971-832-9043
Mailing Address - Fax:
Practice Address - Street 1:2855 HAYES ST
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-1397
Practice Address - Country:US
Practice Address - Phone:971-832-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist