Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | MD00025096 | WA |
N | 207Q00000X | Family Doctor | MD00025096 | WA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | MD00025096 | WA |
NPI | 1710914312 |
---|---|
Provider Name | Dr. Howard L Leibrand |
First Address | Mount Vernon, WA 98273-6565 |
Second Address | Burlington, WA 98233-3314 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 07/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E53921 | (02) |