Provider Demographics
NPI:1396328407
Name:LEON, ANDREW ALLEN (SUDP)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:ALLEN
Last Name:LEON
Suffix:
Gender:M
Credentials:SUDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:518 S BROWNE ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2315
Mailing Address - Country:US
Mailing Address - Phone:509-456-5465
Mailing Address - Fax:509-456-5710
Practice Address - Street 1:1123 W FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-3433
Practice Address - Country:US
Practice Address - Phone:661-497-0505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP61388977101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)