Provider Demographics
NPI:1326118902
Name:STUDZINSKI, LEO G (DC DOCTOR OF CHIRO)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:G
Last Name:STUDZINSKI
Suffix:
Gender:M
Credentials:DC DOCTOR OF CHIRO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11734 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-364-9501
Mailing Address - Fax:206-440-8453
Practice Address - Street 1:11734 15TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-364-9501
Practice Address - Fax:206-440-8453
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002177111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALI 37999OtherL & I
T02029Medicare UPIN