PREMISE HEALTH OF OHIO MEDICAL P.A NPI 1063770196

NPI Information

  • NPI: 1063770196
  • Provider Name: PREMISE HEALTH OF OHIO MEDICAL, P.A
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: LIVING WELL HEALTH CENTER
  • Address: 3925 159TH AVE NE
    REDMOND, WA
    ZIP 98052
  • Phone: (425) 216-0550

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NPI Details

PREMISE HEALTH OF OHIO MEDICAL, P.A is a primary care clinic center in Redmond, WA. PREMISE HEALTH OF OHIO MEDICAL, P.A NPI is 1063770196. The provider is registered as an organization entity type.
The provider Is Doing Business As Living Well Health Center.

The provider's business location address is:

3925 159TH AVE NE
REDMOND, WA
ZIP 98052-309
Phone: (425) 216-0550
Fax: (425) 216-0551

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The enumeration date for this NPI number is 4/26/2012 and was last updated on 8/16/2022.

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
1261QP2300XClinic/CenterPrimary CareYes

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: 3/30/2025

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