Organization
FREDERICK D LEIST MD INC PS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUZANNE M FLETCHER (PRACTICE ADMINISTRATOR)
(360) 479-4370
Entity
Organization
Contact information
Practice address
2600 CHERRY AVE, SUITE 201, BREMERTON, WA 98310-4213
(360) 479-4370
(360) 792-1166
Mailing address
2600 CHERRY AVE, SUITE 201, BREMERTON, WA 98310-4213
(360) 479-4370
(360) 792-1166
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00010979
WA
Other
Enumeration date
08/16/2007
Last updated
10/11/2007
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