Provider Demographics
NPI:1710248232
Name:DAVIS, LEANNA JEAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LEANNA
Middle Name:JEAN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1322 3RD ST SE STE 20
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-3771
Mailing Address - Country:US
Mailing Address - Phone:253-697-1356
Mailing Address - Fax:253-770-5175
Practice Address - Street 1:1322 3RD ST SE STE 20
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-3771
Practice Address - Country:US
Practice Address - Phone:253-697-1356
Practice Address - Fax:253-770-5175
Is Sole Proprietor?:No
Enumeration Date:2012-05-31
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH601514901835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy