Healthcare Provider Details

I. General information

NPI: 1568514032
Provider Name (Legal Business Name): THOMAS D. LENART M.D., PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17130 AVONDALE WAY SUITE 111
REDMOND WA
98052-4455
US

IV. Provider business mailing address

12333 NE 130TH LN STE 440
KIRKLAND WA
98034-7467
US

V. Phone/Fax

Practice location:
  • Phone: 425-885-6600
  • Fax: 425-885-6580
Mailing address:
  • Phone: 425-899-3838
  • Fax: 425-899-3844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD00037554
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: