Provider Demographics
NPI:1306312889
Name:ANDERSON, ELIZABETH A
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:99130-8755
Mailing Address - Country:US
Mailing Address - Phone:509-635-0502
Mailing Address - Fax:
Practice Address - Street 1:103 N 8TH ST
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:WA
Practice Address - Zip Code:99130-8755
Practice Address - Country:US
Practice Address - Phone:509-635-0502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula