Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | MD00037999 | WA |
N | 207SG0201X | Clinical Genetics (M.D.) | MD19555 | OR |
Y | 208000000X | Pediatrician | MD00037999 | WA |
N | 208000000X | Pediatrician | MD19555 | OR |
NPI | 1053424846 |
---|---|
Provider Name | Leesa M Linck |
First Address | Wenatchee, WA 98801-2028 |
Second Address | Winthrop, WA 98862 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 04/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053424846 | (05) | WA |