Provider Demographics
NPI:1487665758
Name:LEEWARD, LINDA LEA (DMD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LEA
Last Name:LEEWARD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 OLIVE WAY
Mailing Address - Street 2:STE 1705 MEDICAL DENTAL BUILDING
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:206-467-6875
Mailing Address - Fax:206-470-0242
Practice Address - Street 1:509 OLIVE WAY
Practice Address - Street 2:STE 1705 MEDICAL DENTAL BUILDING
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-467-6875
Practice Address - Fax:206-470-0242
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE0000600D122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist