=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659488542
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BARBARA LEVY, M.D., P.S.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/24/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 34503 9TH AVE S STE 330
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98003-8726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-838-3695
-----------------------------------------------------
Fax | 253-661-1987
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 34503 9TH AVE S STE 330
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98003-8726
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-838-3695
-----------------------------------------------------
Fax | 253-661-1987
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | BARBARA SUSAN LEVY
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 253-838-3695
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | MD00019274
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------