Provider Demographics
NPI:1407843279
Name:SEIFTER, LEONARD STEWART (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:STEWART
Last Name:SEIFTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 LILLY RD NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5428
Mailing Address - Country:US
Mailing Address - Phone:360-438-2207
Mailing Address - Fax:360-438-2231
Practice Address - Street 1:300 LILLY RD NE
Practice Address - Street 2:SUITE C
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5428
Practice Address - Country:US
Practice Address - Phone:360-438-2207
Practice Address - Fax:360-438-2231
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00023118207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7087539Medicaid
WAAS1364431OtherDEA
WAAS1364431OtherDEA