Organization
PREMISE HEALTH OF WASHINGTON MEDICAL, P.C.
Active
Other names
T-Mobile-Bellevue
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN LEIZMAN MD (PRESIDENT)
(615) 468-6270
Entity
Organization
Contact information
Practice address
3625 132ND AVE SE FL 1, BELLEVUE, WA 98006-1325
(425) 651-7510
(425) 378-7843
Mailing address
5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2024
Last updated
05/29/2024
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