Provider Demographics
NPI:1922800671
Name:GETLEAN15LLC
Entity type:Organization
Organization Name:GETLEAN15LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MASTER TRAINER
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-928-0454
Mailing Address - Street 1:21651 E COUNTRY VISTA DR STE C
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7709
Mailing Address - Country:US
Mailing Address - Phone:509-928-0454
Mailing Address - Fax:
Practice Address - Street 1:21651 E COUNTRY VISTA DR STE C
Practice Address - Street 2:
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-7709
Practice Address - Country:US
Practice Address - Phone:509-928-0454
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305S00000XManaged Care OrganizationsPoint of Service