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Organization

EASTSIDE UROLOGY ASSOCIATES PS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LINDA L LEIGHTON (ADMINISTRATOR)
(425) 899-5801
Entity
Organization

Contact information

Practice address
11911 NE 132ND ST, SUITE 200, KIRKLAND, WA 98034-2900
(425) 899-5800
(425) 899-5806
Mailing address
11911 NE 132ND ST, SUITE 200, KIRKLAND, WA 98034-2900
(425) 899-5800
(425) 899-5806

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
36112
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
A05679G
MEDICARE ID-PIN
WA
01
A55329G
MEDICARE ID-PIN
WA
01
H31729G
MEDICARE ID-PIN
WA
01
I10719G
MEDICARE ID-PIN
WA
01
I13494G
MEDICARE ID-PIN
WA
01
I62620G
MEDICARE ID-PIN
WA
Enumeration date
02/28/2006
Last updated
08/05/2010
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