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Individual

ELDON LESTER LEINWEBER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
22 WEST HIGHWAY 28, SOAP LAKE, WA 98851
(509) 888-9606
(509) 683-1135
Mailing address
PO BOX 1050, SOAP LAKE, WA 98851-1050
(509) 888-9606
(509) 683-1135

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004217
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0193143
LABOR &INDUSTRIES ID #
WA
01
1051425
NCCPA CERTIFICATION
WA
01
211648
LABOR & INDUSTRIES ID #
WA
01
6612LE
REGENCE PROVIDER #
WA
05
8418451
WA
Enumeration date
03/17/2006
Last updated
03/07/2023
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