Provider Demographics
NPI:1851117311
Name:HOPPE-LEONARD, NOLAN P (LMT)
Entity type:Individual
Prefix:
First Name:NOLAN
Middle Name:P
Last Name:HOPPE-LEONARD
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4107 236TH ST SW APT M303
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-4318
Mailing Address - Country:US
Mailing Address - Phone:425-381-5555
Mailing Address - Fax:
Practice Address - Street 1:7330 NE BOTHELL WAY STE 204
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-6525
Practice Address - Country:US
Practice Address - Phone:425-381-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61093900225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist