Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD 00023573 | WA |
NPI | 1003134941 |
---|---|
Provider Name | Dr. Leandro Pasos |
First Address | Seattle, WA 98116-1911 |
Second Address | Seattle, WA 98125-4403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2010 |
Last Update Date | 15/05/2010 |