Provider Demographics
NPI:1518144120
Name:LEVA INCORPORATED
Entity Type:Organization
Organization Name:LEVA INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:ELLINOR
Authorized Official - Last Name:SWEET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-438-6001
Mailing Address - Street 1:4704 PACIFIC AVE SE
Mailing Address - Street 2:STE. B
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1200
Mailing Address - Country:US
Mailing Address - Phone:360-438-6001
Mailing Address - Fax:
Practice Address - Street 1:4704 PACIFIC AVE SE
Practice Address - Street 2:STE. B
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-1200
Practice Address - Country:US
Practice Address - Phone:360-438-6001
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034424111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACH00034424OtherWASHINGTON STATE LICENSE