# AESTHETIC & GENERAL DERMATOLOGY OF SEATTLE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902043284
- **Authorized official:** DR. ELIE LEVY MD (OWNER)
- **Authorized official phone:** (206) 248-5020

## Contact information

- **Practice address:** 13610 1ST AVE S, BURIEN, WA 98168-3404
- **Practice address phone:** (206) 245-8502
- **Practice address fax:** (206) 244-8425
- **Mailing address:** 13610 1ST AVE S, BURIEN, WA 98168-3404
- **Mailing address phone:** (206) 245-8502
- **Mailing address fax:** (206) 244-8425

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/08/2009
- **Last updated:** 05/25/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 7089576 | — | WA |