Provider Demographics
NPI:1730335944
Name:PREBLE, LEANNE D (LIC AC, M AC)
Entity type:Individual
Prefix:MRS
First Name:LEANNE
Middle Name:D
Last Name:PREBLE
Suffix:
Gender:F
Credentials:LIC AC, M AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7238 NE WILLIAM ROGERS RD
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:WA
Mailing Address - Zip Code:98342-9705
Mailing Address - Country:US
Mailing Address - Phone:206-909-9274
Mailing Address - Fax:
Practice Address - Street 1:945 HILDEBRAND LN NE STE 231
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2877
Practice Address - Country:US
Practice Address - Phone:206-909-9274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 00003064171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist