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Individual

MR. JOHNNY LEE LEBORD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.P.

Contact information

Practice address
9001 35TH AVE SW, SEATTLE, WA 98126-3820
(206) 755-0008
(206) 933-6088
Mailing address
15539 MERIDIAN AVE N, SHORELINE, WA 98133-6038
(206) 755-0008
(206) 933-6088

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00015163
WA

Other

Enumeration date
05/08/2007
Last updated
07/08/2007
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