Provider Demographics
NPI:1730215203
Name:LEVINE, RICHARD IRA (DC)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:IRA
Last Name:LEVINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 WAIALAE AVE.
Mailing Address - Street 2:PMB 247
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-5767
Mailing Address - Country:US
Mailing Address - Phone:808-797-8094
Mailing Address - Fax:808-200-3607
Practice Address - Street 1:10500 NE 8TH ST STE 212
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4351
Practice Address - Country:US
Practice Address - Phone:425-455-0332
Practice Address - Fax:425-455-0417
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6833111N00000X
HIDC1331111N00000X
WA2630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA217000477Medicare ID - Type Unspecified
WA001201410Medicare UPIN