Provider Demographics
NPI:1871752048
Name:LEUNG, JOANNA L (PHD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:L
Last Name:LEUNG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:S
Other - Last Name:LAU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:545 RAINIER BLVD N
Mailing Address - Street 2:STE 21B
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-2806
Mailing Address - Country:US
Mailing Address - Phone:563-355-9200
Mailing Address - Fax:563-355-3419
Practice Address - Street 1:545 RAINIER BLVD N
Practice Address - Street 2:STE 21B
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2806
Practice Address - Country:US
Practice Address - Phone:563-355-2577
Practice Address - Fax:563-355-4015
Is Sole Proprietor?:No
Enumeration Date:2008-06-03
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60471728103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical