LEYTON ENDICOTT JUMP NPI 1790741924

NPI Information

NPI: 1790741924
Provider Name: LEYTON ENDICOTT JUMP
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
273 SUSSEX AVE E
TENINO, WA
ZIP 98589
Phone: (360) 264-5665
Get Directions

Leyton Endicott Jump is a general practice in Tenino, WA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee Leyton Endicott Jump NPI is 1790741924. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

273 SUSSEX AVE E
TENINO, WA
ZIP 98589-359
Phone: (360) 264-5665
Fax: (360) 264-5666

The NPI 1790741924 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/25/2006 and was last updated on 2/26/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice		MD00022762	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	G8856183	OTHER		MEDICARE
2	A08291	MEDICARE UPIN
3	101589	OTHER		BLACK LUNG
4	G8856183	OTHER		PTAN
5	90836	OTHER	WASHINGTON	LABOR & INDUSTRIES
6	T01236	OTHER		REGENCE
7	1005719	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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