Provider Demographics
NPI:1528193398
Name:LEININGER, CHRISTOPHER JERRELL (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:JERRELL
Last Name:LEININGER
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 1:1600 E JEFFERSON ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5698
Mailing Address - Country:US
Mailing Address - Phone:206-215-4300
Mailing Address - Fax:206-215-4315
Practice Address - Street 1:1600 E JEFFERSON ST
Practice Address - Street 2:SUITE 115
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5698
Practice Address - Country:US
Practice Address - Phone:206-215-4300
Practice Address - Fax:206-215-4315
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00015230207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8241580Medicaid
WA8241580Medicaid
WAAB20663Medicare ID - Type Unspecified