Organization
LEYTON ENDICOTT JUMP
Active
Other names
Tenino Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEYTON ENDICOTT JUMP MD (OWNER)
(360) 264-5665
Entity
Organization
Contact information
Practice address
273 SUSSEX AVE E, TENINO, WA 98589-9359
(360) 264-5665
(360) 264-5666
Mailing address
PO BOX 4020, TENINO, WA 98589-4020
(360) 264-5665
(360) 264-5666
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00022762
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
122559
LABOR & INDUSTRIES
WA
05
—
7102478
—
WA
Enumeration date
04/25/2006
Last updated
06/04/2013
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