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Individual

GREG L LEDGERWOOD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
520 W INDIAN AVE, BREWSTER, WA 98812
(509) 689-2525
(509) 689-3247
Mailing address
PO BOX 337, BREWSTER, WA 98812-0337
(509) 689-2525
(509) 689-3247

Taxonomy

Speciality
Code
Description
License number
State
207KI0005X
Clinical & Laboratory Immunology (Allergy & Immunology) Physician
MD00012638
WA
207Q00000X
Family Medicine Physician
Primary
MD00012638
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003813
WA
01
202565
L&I
Enumeration date
03/29/2006
Last updated
03/04/2008
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