Healthcare Provider Details

I. General information

NPI: 1336797620
Provider Name (Legal Business Name): ETS CONSULTING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2019
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24255 VAN RY BLVD STE A2
MOUNTLAKE TERRACE WA
98043
US

IV. Provider business mailing address

24255 VAN RY BLVD STE A2
MOUNTLAKE TERRACE WA
98043-5460
US

V. Phone/Fax

Practice location:
  • Phone: 425-672-5800
  • Fax: 425-672-5811
Mailing address:
  • Phone: 425-672-5800
  • Fax: 425-672-5811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: LISA MARIE ANDERSON
Title or Position: GENERAL MANAGER
Credential:
Phone: 425-672-5800