Individual
MARK R LEVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 NE GILMAN BLVD, ISSAQUAH, WA 98027-2925
(425) 557-8000
Mailing address
1100 9TH AVE, MS:M4-PA, SEATTLE, WA 98101-2756
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00020970
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039581
LABOR & INDUSTRY
WA
05
—
8599003
—
WA
01
—
L587
BLUE SHIELD
WA
01
—
US4120494
AETNA/USHC SPECIALIST
WA
Enumeration date
07/31/2006
Last updated
09/14/2012
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