Dpmleonheartprwa LLC
Organization Active NPI Foot & Ankle Surgery Podiatrist · Puyallup, WA
NPI 1326229485 · NPPES record last updated Oct 10, 2008
Key facts
- NPI
- 1326229485
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- PO00000778 (WA)
- Legal business name
- DPMLEONHEARTPRWA LLC
- Practice address
- 10116 116TH St E
Suite 103
Puyallup, WA 98373-3543 - Phone
- (253) 841-3668
- NPI assigned
- Nov 16, 2007
- Organization subpart
- No
Authorized official
- Name
- Eric Edward Leonheart
- Title
- Owner
- Phone
- (253) 841-3668
Practitioners 5
-
Kevin Dale Adolf, DPM
-
Heather L Salton, DPM
-
Eddie Davis, DPM
National Provider Directory
Locations
112 43rd Ave SW
Ste 103
Puyallup, WA 98373
Phone (253) 841-3410
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist |
213ES0103X | PO00000778 | WA | Yes |
Addresses
Primary practice location
10116 116TH St E
Suite 103
Puyallup, WA 98373-3543
Mailing address
11201 88TH Ave E
Suite 210
Puyallup, WA 98373-3802
Phone (253) 841-3668
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1121714 | Medicaid | WA |
Other providers in Puyallup, WA
- Miroslava Dostan
- Double Diamond Massage
- Brooke S Douglas
- Hailey Dow
- Susan R Downey
- Dpmsaltonprwa LLC
- Dr Patrice N Stevenson
- Dr. Hector M Bush, PC
- Dr. Nikolina Nielsen
- Dr. Patrick Demarco, PHD, PLLC
All providers in Puyallup, WA · Foot & Ankle Surgery Podiatrist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.