Brottem, John Leonard
Brottem, John Leonard is an individual health care provider with primary practice located at 500 Lilly Rd Ne , Olympia WA 98506-5197. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Brottem, John Leonard can be contacted via phone (360) 413-8272.Contact Information
Primary practice address
500 Lilly Rd Ne
Olympia WA 98506-5197
Phone: (360) 413-8272
Fax: (360) 413-8878
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Specialist | 174400000X | MD00018177 | Washington |
Profile Details
NPI number | 1972566818 |
---|---|
LBN Legal business name | Brottem, John Leonard |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 11th, 2006 |
Last updated | Jul 9th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1972566818 | NPPES |
Washington | MEDICAID | 8214801 |
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