Organization
KENT G LEAVITT MD PLLC
Active
Organization
KENT G LEAVITT MD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENT G LEAVITT MD (MEMBER)
(425) 450-6990
Entity
Organization
Contact information
Practice address
14841 179TH AVE SE STE 110, MONROE, WA 98272-1127
(425) 450-6990
(425) 450-8807
Mailing address
1135 116TH AVE NE STE 450, BELLEVUE, WA 98004-4623
(425) 450-6990
(425) 450-8807
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD0028489
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008218
—
WA
Enumeration date
04/10/2009
Last updated
06/11/2014
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