Individual
DR. SHANE COLBY LEAVITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3726 BROADWAY,, SUITE 201, EVERETT, WA 98201
(425) 317-9119
(425) 317-9118
Mailing address
3726 BROADWAY, SUITE 201, EVERETT, WA 98201-3787
(425) 317-9119
(425) 317-9118
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD00049382
WA
390200000X
Student in an Organized Health Care Education/Training Program
0116016876
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8510646
—
WA
Enumeration date
05/17/2007
Last updated
04/27/2017
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