Provider Demographics
NPI:1841295276
Name:LEFFMANN, DAVID JON (MPT)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JON
Last Name:LEFFMANN
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 2ND AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2357
Mailing Address - Country:US
Mailing Address - Phone:206-264-9780
Mailing Address - Fax:
Practice Address - Street 1:506 2ND AVE
Practice Address - Street 2:STE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2357
Practice Address - Country:US
Practice Address - Phone:206-264-9780
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00005718225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB35042Medicare ID - Type UnspecifiedPROVIDER ID #