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Individual
LEYTON ENDICOTT JUMP
Active
Individual
LEYTON ENDICOTT JUMP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD00022762
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005719
—
WA
01
—
101589
BLACK LUNG
—
01
—
90836
LABOR & INDUSTRIES
WA
01
—
G8856183
PTAN
—
01
—
T01236
REGENCE
—
Enumeration date
04/25/2006
Last updated
02/26/2015
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