Healthcare Provider Details

I. General information

NPI: 1255140133
Provider Name (Legal Business Name): ELIZABETH KEELEY LEWIS CRNA, DNAP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH KEELEY LAYRISSON

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 CAPITAL MALL DR SW
OLYMPIA WA
98502-8654
US

IV. Provider business mailing address

PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 360-754-5858
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP61653920
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number153505
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: