Provider Demographics
NPI:1760635221
Name:LIVINGSTONE, SIMON (MD)
Entity Type:Individual
Prefix:
First Name:SIMON
Middle Name:
Last Name:LIVINGSTONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 1ST AVE
Mailing Address - Street 2:SUITE 720
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2158
Mailing Address - Country:US
Mailing Address - Phone:206-949-0027
Mailing Address - Fax:206-448-6945
Practice Address - Street 1:2025 1ST AVE
Practice Address - Street 2:SUITE 720
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2158
Practice Address - Country:US
Practice Address - Phone:206-949-0027
Practice Address - Fax:206-448-6945
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAML600197942084P0800X
WAMD602369092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry