Provider Demographics
NPI:1588931976
Name:BERKERS, ELIZABETH ANN (LMP)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:BERKERS
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 N WINDSOR DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-2054
Mailing Address - Country:US
Mailing Address - Phone:509-474-9911
Mailing Address - Fax:
Practice Address - Street 1:624 W HASTINGS RD
Practice Address - Street 2:SUITE 16
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2862
Practice Address - Country:US
Practice Address - Phone:509-863-6511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2013-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60252074172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker