Individual
DIANNE R. LEVISOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19917 7TH AVE NE, STE 203, POULSBO, WA 98370-6555
(360) 824-5474
(360) 326-2451
Mailing address
19917 7TH AVE NE, STE 203, POULSBO, WA 98370-6555
(360) 824-5474
(360) 326-2451
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00030159
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070004630
RAILROAD MEDICARE
—
01
—
30262
LABOR & INDUSTRIES
WA
01
—
5395002
AETNA
—
05
—
8142234
—
WA
01
—
G8950076
WEST SOUND DERM PTAN
WA
01
—
LE7554
REGENCE BLUE SHIELD
—
Enumeration date
06/01/2006
Last updated
03/07/2023
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