| NPI | 1659717262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK JAMES LEINENBACH Owner 971-226-0118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OR MD153000) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: OR MD153000) |
| 202C00000X Independent Medical Examiner (Licence: WA MD60348035) | |
| 207R00000X Internal Medicine (Licence: WA MD60348035) | |
| 208D00000X General Practice (Licence: OR MD153000) | |
| 208D00000X General Practice (Licence: WA MD60348035) | |
| Enumeration Date | 2013-05-22 |
| Last Update Date | 2013-05-22 |