Provider Demographics
NPI:1780801829
Name:WARHANK, LENNIE (LPN, LMP)
Entity type:Individual
Prefix:
First Name:LENNIE
Middle Name:
Last Name:WARHANK
Suffix:
Gender:F
Credentials:LPN, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9501 STATE AVE
Mailing Address - Street 2:STE A
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-2235
Mailing Address - Country:US
Mailing Address - Phone:360-651-8264
Mailing Address - Fax:360-658-9021
Practice Address - Street 1:9501 STATE AVE
Practice Address - Street 2:STE A
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98270-2235
Practice Address - Country:US
Practice Address - Phone:360-651-8264
Practice Address - Fax:360-658-9021
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALP00026114164W00000X
WAMA00018689175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered164W00000XNursing Service ProvidersLicensed Practical Nurse
Not Answered175L00000XOther Service ProvidersHomeopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0177216OtherDEPT. OF LABOR & INDUSTRI