Provider Demographics
NPI:1619996964
Name:LEONE, JOSEPH P (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:P
Last Name:LEONE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 S 336TH ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6328
Mailing Address - Country:US
Mailing Address - Phone:253-838-6180
Mailing Address - Fax:253-838-6418
Practice Address - Street 1:335 SE 8TH AVE
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4246
Practice Address - Country:US
Practice Address - Phone:503-681-1176
Practice Address - Fax:503-681-1606
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR213247OtherTULHAL
OR213247Medicaid
800810OtherMEDICARE GROUP NO.
OR213247Medicaid
ORP00419455Medicare PIN
WYW138347Medicare PIN
I48049Medicare UPIN