Provider Demographics
NPI:1871715409
Name:GLAMZI, ALMA DE LEON (MD)
Entity type:Individual
Prefix:DR
First Name:ALMA
Middle Name:DE LEON
Last Name:GLAMZI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALMA AURORA
Other - Middle Name:LAZARO
Other - Last Name:DE LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4700 POINT FOSDICK DR STE 202
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1706
Mailing Address - Country:US
Mailing Address - Phone:253-858-9192
Mailing Address - Fax:253-627-7880
Practice Address - Street 1:4700 POINT FOSDICK DR STE 202
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-1706
Practice Address - Country:US
Practice Address - Phone:253-858-9192
Practice Address - Fax:253-627-7880
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD 60071755207Q00000X
WAMD60071755207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8540247Medicaid
WA2001119Medicaid