person
Leyton Endicott Jump
General Practice Physician in Tenino, Washington
NPI 1790741924

Leyton Endicott Jump is a General Practice Physician based in Tenino, WA. Leyton Endicott Jump practices in Tenino, WA. The NPI Number for Leyton Endicott Jump is 1790741924 and holds a License No. MD00022762 (Washington).

The current practice location address for Leyton Endicott Jump is 273 Sussex Ave E, Tenino, WA and can be reached out via phone at 360-264-5665 and via fax at 360-264-5666.

Location: 273 Sussex Ave E, Tenino, WA, 98589-4020
person
Provider Profile Details
NPI Number
1790741924
Provider Name
Leyton Endicott Jump
Credential
Provider Entity Type
Individual
Gender
Male
Address
273 Sussex Ave E, Tenino, WA, 98589-4020
Phone Number
360-264-5665
Fax Number
360-264-5666
Provider Enumeration Date
04/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1005719 05 WA
90836 01 WA LABOR & INDUSTRIES
G8856183 01 PTAN
G8856183 01 MEDICARE
T01236 01 REGENCE
101589 01 BLACK LUNG
institution
Provider Business Practice Location Address Details
Address
273 Sussex Ave E
City
State
Zip
98589-9359
Phone Number
360-264-5665
Fax Number
360-264-5666
person
Provider Business Mailing Address Details
Address
273 Sussex Ave E
City
State
Zip
98589-9359
Phone Number
360-264-5665
Fax Number
360-264-5666
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
MD00022762 (Washington)
Definition
Definition to come...
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