Provider Demographics
NPI:1366573941
Name:RAY-COLBY, LEANNA JEAN (APN,MN,RN,DE)
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:JEAN
Last Name:RAY-COLBY
Suffix:
Gender:F
Credentials:APN,MN,RN,DE
Other - Prefix:
Other - First Name:LEANNA
Other - Middle Name:JEAN
Other - Last Name:RAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APN,MN,RN,DE
Mailing Address - Street 1:PO BOX 317
Mailing Address - Street 2:
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357-0317
Mailing Address - Country:US
Mailing Address - Phone:360-452-6252
Mailing Address - Fax:360-452-6274
Practice Address - Street 1:243511 W HIGHWAY 101
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98363-9472
Practice Address - Country:US
Practice Address - Phone:360-452-6252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00060254364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist