Healthcare Provider Details

I. General information

NPI: 1407892466
Provider Name (Legal Business Name): LEONARD C. ALTMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 09/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9725 3RD AVE NE STE 500
SEATTLE WA
98115-2024
US

IV. Provider business mailing address

9725 3RD AVE NE STE 500
SEATTLE WA
98115-2024
US

V. Phone/Fax

Practice location:
  • Phone: 206-527-1200
  • Fax: 206-527-0535
Mailing address:
  • Phone: 206-527-1200
  • Fax: 206-527-1200

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD00011606
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: