Provider Demographics
NPI:1215054705
Name:LEVY, D'VORAH RUTH (MAC, LAC)
Entity type:Individual
Prefix:
First Name:D'VORAH
Middle Name:RUTH
Last Name:LEVY
Suffix:
Gender:F
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 EASTLAKE AVE E
Mailing Address - Street 2:#302
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3366
Mailing Address - Country:US
Mailing Address - Phone:206-322-6053
Mailing Address - Fax:206-322-6504
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:#302
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:206-322-6053
Practice Address - Fax:206-322-6504
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00000162171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist