Provider Demographics
NPI:1407874795
Name:LEONARD, EDWARD EARL II (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:EARL
Last Name:LEONARD
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1200 116TH AVE NE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3802
Mailing Address - Country:US
Mailing Address - Phone:425-455-8248
Mailing Address - Fax:425-462-1643
Practice Address - Street 1:1200 116TH AVE NE
Practice Address - Street 2:SUITE D
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3802
Practice Address - Country:US
Practice Address - Phone:425-455-8248
Practice Address - Fax:425-462-1643
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2013-07-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WA00033910207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1117035Medicaid
WAAB33793Medicare ID - Type Unspecified
WA1117035Medicaid