Healthcare Provider Details
I. General information
NPI: 1003957655
Provider Name (Legal Business Name): HENRY S. LEVINE, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/08/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1326 E LAUREL ST
BELLINGHAM WA
98225-5739
US
IV. Provider business mailing address
1326 E LAUREL ST
BELLINGHAM WA
98225-5739
US
V. Phone/Fax
- Phone: 360-671-0383
- Fax: 360-756-8850
- Phone: 360-671-0383
- Fax: 360-756-8850
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD00013425 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | MD00013425 |
| License Number State | WA |
VIII. Authorized Official
Name:
KRISTI
L
PETERS
Title or Position: OFFICE MANAGER
Credential:
Phone: 360-671-0383