Provider Demographics
NPI:1174726574
Name:ANNE LEEFELDT KANTERS, PHD, P.S.
Entity type:Organization
Organization Name:ANNE LEEFELDT KANTERS, PHD, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:LEEFELDT
Authorized Official - Last Name:KANTERS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-683-9881
Mailing Address - Street 1:225 N SEQUIM AVE
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3456
Mailing Address - Country:US
Mailing Address - Phone:360-683-9881
Mailing Address - Fax:360-683-2125
Practice Address - Street 1:225 N SEQUIM AVE
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3456
Practice Address - Country:US
Practice Address - Phone:360-683-9881
Practice Address - Fax:360-683-2125
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002724103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8857004Medicare PIN