Walter Shad Leitch, M.D.

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

M-8488 Issued in ID

Practice address

Madigan Army Medical Center 9040 Jackson Ave
Tacoma, WA 98431-1100

Phone

(253) 968-1290

Fax

(253) 968-0448

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560988800000",
    "number": "1295825255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVE ATTN: CREDENTIALS OFFICE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1290",
            "fax_number": "253-968-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CENTER 9040 JACKSON AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-1290",
            "fax_number": "253-968-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEITCH",
        "first_name": "WALTER",
        "middle_name": "SHAD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "ID",
            "license": "M-8488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daren Philip Leines, PT
• Shannon Leingang, EAMP
• Ananda Duprey Leininger, LMHC
• Kirby Leininger, CRNA
• Michael Carlson Leisle, MD
• Alexandrea L Leiter, OT
• Mishaya Jovon Leiter
• Marina Leith, DO
• Gloria Neary Lem, ARNP
• Stephanie Lemay, PA-C

• Endocrinology, Diabetes & Metabolism Physician in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Endocrinology, Diabetes & Metabolism Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.