Basic Information
Provider Information
NPI: 1659859056
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LEIMGRUBER
FirstName: ASHLEY
MiddleName: JAN
NamePrefix:  
NameSuffix:  
Credential: DNAP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 94645
Address2:  
City: SEATTLE
State: WA
PostalCode: 981246945
CountryCode: US
TelephoneNumber: 8553944445
FaxNumber:  
Practice Location
Address1: 101 W 8TH AVE
Address2:  
City: SPOKANE
State: WA
PostalCode: 992042307
CountryCode: US
TelephoneNumber: 5094743181
FaxNumber: 5092277070
Other Information
ProviderEnumerationDate: 07/30/2018
LastUpdateDate: 09/26/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN60090911WAN Nursing Service ProvidersRegistered Nurse 
367500000XAP60892120WAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home