Active NPI
Shannon M Leach, ARNP
- Family Nurse Practitioner
- Everett, WA
National Provider Identifier
1285918938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- AP60247426
- Practice address
- 1700 13TH St
Everett, WA 98201-1689 - Phone
- (425) 404-5345
- Fax
- (425) 404-5330
- NPI assigned
- Sep 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP60247426 | WA | Primary |
Addresses
Primary practice location
1700 13TH St
Everett, WA 98201-1689
Mailing address
PO Box 3360
Portland, OR 97208-3360
Phone (866) 747-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AP60247426 | Other | WA | WSL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP60247426 | WA | MD | Family Nurse Practitioner |
Interoperability endpoints
- shannon.leach.1@20612.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1317254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447286400000",
"number": "1285918938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3360",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083360",
"telephone_number": "866-747-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 13TH ST",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011689",
"telephone_number": "425-404-5345",
"fax_number": "425-404-5330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEACH",
"first_name": "SHANNON",
"middle_name": "M",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-29",
"last_updated": "2015-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WA",
"license": "AP60247426",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WSL",
"identifier": "AP60247426",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.