Provider Demographics
NPI:1821462573
Name:HOPPE-LEONARD, JAREN MICHAEL (LSWAIC, LMT)
Entity Type:Individual
Prefix:
First Name:JAREN
Middle Name:MICHAEL
Last Name:HOPPE-LEONARD
Suffix:
Gender:M
Credentials:LSWAIC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 LAKEWAY DR
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5236
Mailing Address - Country:US
Mailing Address - Phone:425-773-6438
Mailing Address - Fax:
Practice Address - Street 1:600 LAKEWAY DR
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5236
Practice Address - Country:US
Practice Address - Phone:360-676-6749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-18
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60580757174400000X
WASC613060561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No174400000XOther Service ProvidersSpecialist