MEDICARE: LEVI BALE MD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1104528397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEVI BALE MD

Provider Business Mailing Address
First Line	:	101 W 8TH AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99204-2307
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1959 NE PACIFIC ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98195-2307
Country	:	US
Telephone Number	:	206-685-0936
Fax Number	:

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

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	06/22/2024

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Directions to “ LEVI BALE MD” Practice Location

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