Healthcare Provider Details

I. General information

NPI: 1619242294
Provider Name (Legal Business Name): MARIJOYCE R. LEYNES, DDS, MSD, P.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2012
Last Update Date: 03/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 C ST SUITE #226
BELLINGHAM WA
98225-4000
US

IV. Provider business mailing address

2522 CRESTLINE DR
BELLINGHAM WA
98226-4209
US

V. Phone/Fax

Practice location:
  • Phone: 360-383-6824
  • Fax: 360-676-4969
Mailing address:
  • Phone: 206-553-9302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDE60228332
License Number StateWA

VIII. Authorized Official

Name: DR. MARIJOYCE RAMOS LEYNES
Title or Position: OWNER
Credential: D.D.S, M.S.D.
Phone: 206-553-9302