Provider Demographics
NPI:1134929516
Name:VENEKLASEN, LEANN
Entity type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:VENEKLASEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 SE 184TH AVE UNIT 204
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-1937
Mailing Address - Country:US
Mailing Address - Phone:719-469-2630
Mailing Address - Fax:
Practice Address - Street 1:312 SE STONEMILL DR STE 135
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-3508
Practice Address - Country:US
Practice Address - Phone:360-356-1114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program