| Doctor Name: | FREDERICK D LEIST |
| NPI Number: | 1013044254 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | MD00010979 |
| Business Practice Address: | 2600 Cherry Avenue Suite 201 Bremerton, WA - 98310 |
| Business Phone Number: | 3604794370 |
| Business Fax Number: | 3607921166 |
| Mailing Address: | 2600 Cherry Avenue, Suite 201 BREMERTON |
| State: | WA |
| Postal Code: | 98310 |
| Phone Number: | 3604794370 |
| Fax Number: | 3607921166 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 10/12/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | MD00010979 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |