Provider Demographics
NPI:1396103131
Name:WARNER, LEYNA (MED, CMHS)
Entity type:Individual
Prefix:
First Name:LEYNA
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:MED, CMHS
Other - Prefix:
Other - First Name:LEYNA
Other - Middle Name:
Other - Last Name:MONEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8212 E D ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-1042
Mailing Address - Country:US
Mailing Address - Phone:907-378-1580
Mailing Address - Fax:
Practice Address - Street 1:8212 E D ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-1042
Practice Address - Country:US
Practice Address - Phone:907-378-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60341040101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health