Leon Douglas Eagle Tail, MSW, CDP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CP00004360 Issued in WA

Practice address

224 N Willow Rd
Spokane Valley, WA 99206-6812

Phone

(509) 927-3837

NPI assigned

Sep 4, 2007

Last updated

Sep 4, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1780878694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N WILLOW RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066812",
            "telephone_number": "509-927-3837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N WILLOW RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992066812",
            "telephone_number": "509-927-3837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGLE TAIL",
        "first_name": "LEON",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "MSW, CDP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC00025859",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CP00004360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Dyck, PH.D.
• Michael Albert Dye, R.PH.
• Dynamic Medical Systems, Inc.
• Ea Healing Arts LLC (Elzbieta H Anderson L.Ac.)
• Philip Eager, LSW
• Carla L Eagleburger, COTA/L, LMT
• Tricia M Earhart, ARNP
• East Valley School District Spokane
• Kyla Aaron Eastman-Stratton, LMP
• Jennifer M Eastman

• Addiction (Substance Use Disorder) Counselor in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.