Individual
MR. LEO M CANONIZADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
450 SO. KITSAP BLVD., SUITE 100, PORT ORCHARD, WA 98366
(360) 744-6275
(360) 744-6188
Mailing address
2520 CHERRY AVE, HARRISON MEDICAL CENTER, BREMERTON, WA 98310
(360) 792-6610
(360) 744-6188
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
12/19/2005
Last updated
03/24/2009
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