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NPI Code Detail

MEDICARE: LEILA FREDERICK

MEDICARE: LEILA FREDERICK
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
1237700000XHearing Instrument SpecialistHA00003450WA

General Provider Information

NPI Number : 1518067917
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEILA FREDERICK
Provider Business Mailing Address
First Line : 5000 CHESHIRE LANE NORTH
Second Line :
City : PLYMOUTH
State : MN
Zip : 55446
Country : US
Telephone Number : 888-333-9152
Fax Number :
Provider Business Practice Location Address
First Line : 1402 N DIVISION
Second Line : SUITE B
City : SPOKANE
State : WA
Zip : 99202
Country : US
Telephone Number : 509-327-7078
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 07/08/2007

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Directions to “ LEILA FREDERICK ” Practice Location

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