Individual
CHARLES KENNETH LEONARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1016 TACOMA AVE, SUNNYSIDE COMMUNITY HOSPITAL, SUNNYSIDE, WA 98944-2263
(509) 837-1500
(509) 837-1584
Mailing address
PO BOX 487, MABTON, WA 98935
(509) 894-5559
(309) 403-8642
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
38956
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
43762
L & I
—
05
—
9606591
—
WA
Enumeration date
05/03/2006
Last updated
09/14/2010
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