Leyton Jump Md Sole Member | |
273 Sussex Ave E Tenino WA 98589-9359 | |
(360) 264-5665 | |
(360) 264-5666 |
Full Name | Leyton Jump Md Sole Member |
---|---|
Speciality | Family Medicine - Adolescent Medicine |
Location | 273 Sussex Ave E, Tenino, Washington |
Authorized Official Name and Position | Leyton Endicott Jump (SOLE MEMBER) |
Authorized Official Contact | 3602645665 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Leyton Jump Md Sole Member Po Box 4020 Tenino WA 98589-4020 Ph: (360) 264-5665 | Leyton Jump Md Sole Member 273 Sussex Ave E Tenino WA 98589-9359 Ph: (360) 264-5665 |
NPI Number | 1487056511 |
---|---|
Provider Enumeration Date | 09/19/2014 |
Last Update Date | 09/19/2014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487056511 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207QA0000X | Family Medicine - Adolescent Medicine | MD00022762 (Washington) | Primary |
Tenino Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 273 Sussex Ave E, Tenino, WA 98589 Phone: 360-264-5665 Fax: 360-264-5666 | |
Valley View Health Center - Tenino Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 273 Sussex Ave E, Tenino, WA 98589 Phone: 360-264-5665 Fax: 360-264-5666 |