Healthcare Provider Details

I. General information

NPI: 1114941762
Provider Name (Legal Business Name): NORTHWEST PEDIATRICS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11545 15TH AVE NE
SEATTLE WA
98125-6358
US

IV. Provider business mailing address

11545 15TH AVE NE
SEATTLE WA
98125-6358
US

V. Phone/Fax

Practice location:
  • Phone: 206-364-2010
  • Fax: 206-364-2432
Mailing address:
  • Phone: 206-364-2010
  • Fax: 206-364-2432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateWA

VIII. Authorized Official

Name: DR. RHONDA L LEVITT
Title or Position: MEMBER, PLLC
Credential: M.D.
Phone: 206-364-2010