Provider Demographics
NPI:1063631471
Name:LEVY, SIERRA L (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:SIERRA
Middle Name:L
Last Name:LEVY
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1993 S KIHEI RD STE 216
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7838
Mailing Address - Country:US
Mailing Address - Phone:808-879-6159
Mailing Address - Fax:
Practice Address - Street 1:1993 S KIHEI RD
Practice Address - Street 2:SUITE 211
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-7834
Practice Address - Country:US
Practice Address - Phone:808-879-6159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI836171100000X
HI145175F00000X
OR946175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist