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General NPI Number Information
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NPI Number | 1841381704
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Entity Type | Individual
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Provider Name | LEONARD T SU MD
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 02/25/2015
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Provider Practice Location Address
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Address Line | 12303 NE 130TH LN SUITE 250
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City | KIRKLAND
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State | WA
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Zip | 98034-3099
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Country | US
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Telephone | 425-453-1772
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Fax | 425-453-0603
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Provider Business Mailing Address
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Address Line | 1135 116TH AVE NE STE 305
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City | BELLEVUE
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State | WA
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Zip | 98004-4623
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Country | US
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Telephone | 180-024-3585
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Fax | 206-824-9510
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | MD00045231
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License Number State | WA
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