Provider Demographics
NPI:1629253828
Name:LEVINE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:LEVINE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:IRA
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:425-455-0332
Mailing Address - Street 1:10500 NE 8TH ST STE 212
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4351
Mailing Address - Country:US
Mailing Address - Phone:425-455-0332
Mailing Address - Fax:
Practice Address - Street 1:10500 NE 8TH ST STE 212
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4351
Practice Address - Country:US
Practice Address - Phone:425-455-0332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH2630261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty