Healthcare Provider Details

I. General information

NPI: 1659488542
Provider Name (Legal Business Name): BARBARA LEVY, M.D., P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34503 9TH AVE S STE 330
FEDERAL WAY WA
98003-8726
US

IV. Provider business mailing address

34503 9TH AVE S STE 330
FEDERAL WAY WA
98003-8726
US

V. Phone/Fax

Practice location:
  • Phone: 253-838-3695
  • Fax: 253-661-1987
Mailing address:
  • Phone: 253-838-3695
  • Fax: 253-661-1987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD00019274
License Number StateWA

VIII. Authorized Official

Name: BARBARA SUSAN LEVY
Title or Position: CEO
Credential: M.D.
Phone: 253-838-3695