Provider Demographics
NPI:1588713812
Name:LEVY, RONA L (MSW, PHD, MPH)
Entity type:Individual
Prefix:DR
First Name:RONA
Middle Name:L
Last Name:LEVY
Suffix:
Gender:F
Credentials:MSW, PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 15TH AVE NE
Mailing Address - Street 2:MAILSTOP 354900
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-6250
Mailing Address - Country:US
Mailing Address - Phone:206-543-5917
Mailing Address - Fax:
Practice Address - Street 1:1607 116TH AVE NE
Practice Address - Street 2:SUITE 110
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3049
Practice Address - Country:US
Practice Address - Phone:206-543-5917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA894103TB0200X, 103TC0700X
WA55611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB37194Medicare UPIN