Provider Demographics
NPI:1932828753
Name:LENO, RILEY (CO61344362)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:LENO
Suffix:
Gender:M
Credentials:CO61344362
Other - Prefix:
Other - First Name:SIENA
Other - Middle Name:RENEE
Other - Last Name:BUSHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2530 W GARDNER AVE # B
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1531
Mailing Address - Country:US
Mailing Address - Phone:253-258-2427
Mailing Address - Fax:
Practice Address - Street 1:701 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-6014
Practice Address - Country:US
Practice Address - Phone:509-838-6092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACO61344362101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)