Healthcare Provider Details

I. General information

NPI: 1942740964
Provider Name (Legal Business Name): LEENA ZURAYK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/24/2017
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1522 WESTERN AVE STE 24043
SEATTLE WA
98101-1522
US

IV. Provider business mailing address

1522 WESTERN AVE STE 24043
SEATTLE WA
98101-1522
US

V. Phone/Fax

Practice location:
  • Phone: 818-854-5901
  • Fax:
Mailing address:
  • Phone: 818-854-5901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDE61038004
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: