Individual
PETER J LEYZAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Mailing address
PO BOX 17978, RICHMOND, VA 23226-7978
(804) 288-4453
(804) 288-1621
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
0024170733
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60560078
WA
Other
Enumeration date
03/18/2013
Last updated
03/17/2018
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