MEDICARE: DR. EDWARD EARL LEONARD II MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RI0200X	Infectious Disease Physician	00033910	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407874795
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. EDWARD EARL LEONARD II MD

Provider Business Mailing Address
First Line	:	1200 116TH AVE NE
Second Line	:	SUITE D
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3802
Country	:	US
Telephone Number	:	425-455-8248
Fax Number	:	425-462-1643

Provider Business Practice Location Address
First Line	:	1200 116TH AVE NE
Second Line	:	SUITE D
City	:	BELLEVUE
State	:	WA
Zip	:	98004-3802
Country	:	US
Telephone Number	:	425-455-8248
Fax Number	:	425-462-1643

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/25/2013

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