MEDICARE: DR. FREDERICK WILLIAM MCLEVICH ND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath
2	225700000X	Massage Therapist	MA60600545	WA
3	175F00000X	Naturopath	NT60894146	WA

General Provider Information

NPI Number	:	1760838379
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FREDERICK WILLIAM MCLEVICH ND

Provider Business Mailing Address
First Line	:	9 BRAMBLE WAY
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98229-4406
Country	:	US
Telephone Number	:	360-685-3563
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 BRAMBLE WAY
Second Line	:
City	:	BELLINGHAM
State	:	WA
Zip	:	98229-4406
Country	:	US
Telephone Number	:	618-203-3167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2016
Last Update Date	:	05/15/2019

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