Provider Demographics
NPI:1982273710
Name:LEVHAR ARDON, MAAYAN
Entity type:Individual
Prefix:
First Name:MAAYAN
Middle Name:
Last Name:LEVHAR ARDON
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 1:150 102ND AVE SE UNIT 405
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6290
Mailing Address - Country:US
Mailing Address - Phone:425-436-4540
Mailing Address - Fax:
Practice Address - Street 1:1601 116TH AVE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3010
Practice Address - Country:US
Practice Address - Phone:425-320-5225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA611456591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical