Provider Demographics
NPI:1588331391
Name:LEVESON, NANCY ANN
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:ANN
Last Name:LEVESON
Suffix:
Gender:F
Credentials:
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 98395
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-0395
Mailing Address - Country:US
Mailing Address - Phone:206-380-5766
Mailing Address - Fax:
Practice Address - Street 1:21410 4TH AVE S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-3611
Practice Address - Country:US
Practice Address - Phone:206-380-5766
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC7488171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter