Provider Demographics
NPI:1720822166
Name:BYERS, ELISE NOREEN
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:NOREEN
Last Name:BYERS
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 1:3211 WOODLAND DR SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7830
Mailing Address - Country:US
Mailing Address - Phone:360-970-5701
Mailing Address - Fax:
Practice Address - Street 1:200 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-9539
Practice Address - Country:US
Practice Address - Phone:509-452-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program