Provider Demographics
NPI:1194118208
Name:LIVINGSTON, DAVID C (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:C
Last Name:LIVINGSTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:550 GAGE BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-9532
Mailing Address - Country:US
Mailing Address - Phone:509-942-3627
Mailing Address - Fax:509-627-2983
Practice Address - Street 1:1135 JADWIN AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3434
Practice Address - Country:US
Practice Address - Phone:509-942-3300
Practice Address - Fax:509-946-1868
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2021-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN11018260A207Q00000X
IN02004890A207Q00000X
WAOP60846293207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine