Provider Demographics
NPI:1619097110
Name:SNARE, LEAH R (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEAH
Middle Name:R
Last Name:SNARE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2510 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2916
Mailing Address - Country:US
Mailing Address - Phone:425-258-3331
Mailing Address - Fax:425-258-9648
Practice Address - Street 1:2510 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2916
Practice Address - Country:US
Practice Address - Phone:425-258-3331
Practice Address - Fax:425-258-9648
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA64991223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice