Provider Demographics
NPI:1760280069
Name:LEVI THERAPY
Entity type:Organization
Organization Name:LEVI THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-470-3479
Mailing Address - Street 1:204 W 4TH ST APT 11
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98362-2835
Mailing Address - Country:US
Mailing Address - Phone:703-470-3479
Mailing Address - Fax:
Practice Address - Street 1:204 W 4TH ST APT 11
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98362-2835
Practice Address - Country:US
Practice Address - Phone:703-470-3479
Practice Address - Fax:888-234-5190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health