Healthcare Provider Details

I. General information

NPI: 1720009764
Provider Name (Legal Business Name): LESLIE J KLAFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

723 SW 10TH ST #100
RENTON WA
98057
US

IV. Provider business mailing address

723 SW 10TH ST #100
RENTON WA
98057
US

V. Phone/Fax

Practice location:
  • Phone: 425-251-1720
  • Fax: 425-251-1723
Mailing address:
  • Phone: 425-251-1720
  • Fax: 425-251-1723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD00021403
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: