Van Dyke, Leroy Keith
Van Dyke, Leroy Keith is an sole proprietor health care provider with primary practice located at 3322 Road N Ne , Moses Lake WA 98837-9505. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Van Dyke, Leroy Keith can be contacted via phone (509) 793-9051.Contact Information
Primary practice address
3322 Road N Ne
Moses Lake WA 98837-9505
Phone: (509) 793-9051
Fax: (509) 766-8585
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA10003296 | Washington |
Profile Details
| NPI number | 1306842307 |
|---|---|
| LBN Legal business name | Van Dyke, Leroy Keith |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 23rd, 2005 |
| Last updated | Jan 18th, 2024 - about last year |
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 | 1306842307 | NPPES |
| Washington | MEDICAID | 8421323 |
Popular Providers
-
Valente, Mitchell David
1550 S Pioneer Way , Moses Lake WA 98837-4613 -
Washburn, Ethan D
1550 S Pioneer Way , Moses Lake WA 98837-4613 -
Moberg, Corbin
605 S Coolidge St , Moses Lake WA 98837-1893 -
Williams, Ryan D
605 S Coolidge St , Moses Lake WA 98837-1893 -
Hymas, Brett
1550 S Pioneer Way Ste 100 , Moses Lake WA 98837-4637 -
Burton, Mandi
840 E Hill Ave , Moses Lake WA 98837-2238 -
Stowe, Rich R
1550 S Pioneer Way Ste 100 , Moses Lake WA 98837-4637 -
Hanson-Steen, Angela S.
840 E Hill Ave , Moses Lake WA 98837-2238