Provider Demographics
NPI:1669759718
Name:LEVINE, DAVID Z (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:Z
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7440 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98408-7117
Mailing Address - Country:US
Mailing Address - Phone:253-475-0511
Mailing Address - Fax:253-475-7440
Practice Address - Street 1:7440 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-7117
Practice Address - Country:US
Practice Address - Phone:253-475-0511
Practice Address - Fax:253-475-7440
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001324208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice