Provider Demographics
NPI:1013036805
Name:SKEEN-LEVY, SANDIE (L AC)
Entity Type:Individual
Prefix:
First Name:SANDIE
Middle Name:
Last Name:SKEEN-LEVY
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 686
Mailing Address - Street 2:
Mailing Address - City:ORTING
Mailing Address - State:WA
Mailing Address - Zip Code:98360-0686
Mailing Address - Country:US
Mailing Address - Phone:253-312-8876
Mailing Address - Fax:
Practice Address - Street 1:11803 101ST AVE E
Practice Address - Street 2:SUITE 100
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3473
Practice Address - Country:US
Practice Address - Phone:253-435-1285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000804171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist