Healthcare Provider Details
I. General information
NPI: 1982224507
Provider Name (Legal Business Name): DR. ELIZABETH LUENGAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/23/2020
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
33431 13TH PL S
FEDERAL WAY WA
98003-6357
US
IV. Provider business mailing address
955 POWELL AVE SW
RENTON WA
98057-2908
US
V. Phone/Fax
- Phone: 253-874-7634
- Fax: 253-874-7635
- Phone: 425-277-1311
- Fax: 425-277-1566
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 390200000X |
| Taxonomy | Student in an Organized Health Care Education/Training Program |
| License Number | |
| License Number State | NULL |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | OP61553972 |
| License Number State | WA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: