Provider Demographics
NPI:1578273108
Name:WEST, LEVI (CMMT, LMT)
Entity Type:Individual
Prefix:
First Name:LEVI
Middle Name:
Last Name:WEST
Suffix:
Gender:M
Credentials:CMMT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 4TH AVE APT 635
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-3415
Mailing Address - Country:US
Mailing Address - Phone:425-437-2044
Mailing Address - Fax:
Practice Address - Street 1:2400 4TH AVE APT 635
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-3415
Practice Address - Country:US
Practice Address - Phone:425-437-2044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61301351225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist