Provider Demographics
NPI:1922115153
Name:LEVINE, DEBRA O (MA,OT/L)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:O
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MA,OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 986
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-0986
Mailing Address - Country:US
Mailing Address - Phone:425-688-8266
Mailing Address - Fax:
Practice Address - Street 1:14023 NE 8TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4101
Practice Address - Country:US
Practice Address - Phone:425-688-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA027801 OT 00000311225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist