Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 000799 | WA |
NPI | 1023070018 |
---|---|
Provider Name | Steven Henry Leifheit |
First Address | Renton, WA 98058-1009 |
Second Address | Seattle, WA 98116-4477 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 20/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B18157 | (02) |