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Individual

DR. CHARLES RAYMOND LEUSNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1304 FAWCETT AVE STE 100, TACOMA, WA 98402-1900
(253) 761-4200
(253) 761-4201
Mailing address
PO BOX 1535, TACOMA, WA 98401-1535
(253) 761-4200
(253) 383-3553

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD00048416
WA
2085R0202X
Diagnostic Radiology Physician
MD162032
OR
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00048416
WA
2085R0204X
Vascular & Interventional Radiology Physician
MD162032
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0225749
LABOR AND INDUSTRIES-TRA
WA
01
0225750
LABOR AND INDUSTRIES-UNION AVENUE OPEN MRI
WA
05
1091253
WA
05
500666603
OR
01
8945559
LABOR AND INDUSTRIES CRIME VICTIMS-TRA
WA
01
8945560
LABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRI
WA
Enumeration date
11/15/2006
Last updated
08/30/2024
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