Provider Demographics
NPI:1962778951
Name:MARCOTTE, LEAH MARIE (MD)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:MARIE
Last Name:MARCOTTE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2047
Mailing Address - Country:US
Mailing Address - Phone:425-224-2144
Mailing Address - Fax:425-341-9653
Practice Address - Street 1:64 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2047
Practice Address - Country:US
Practice Address - Phone:425-224-2144
Practice Address - Fax:425-341-9653
Is Sole Proprietor?:No
Enumeration Date:2012-03-24
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML 60288352207R00000X
WAMD60488974207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine