Provider Demographics
NPI:1639594708
Name:SCHELLHORN, LEANNE (MA)
Entity Type:Individual
Prefix:
First Name:LEANNE
Middle Name:
Last Name:SCHELLHORN
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 1:10229 62ND DR NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-6612
Mailing Address - Country:US
Mailing Address - Phone:425-345-3054
Mailing Address - Fax:
Practice Address - Street 1:10229 62ND DR NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-6612
Practice Address - Country:US
Practice Address - Phone:425-345-3054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-26
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60436105174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist