Healthcare Provider Details

I. General information

NPI: 1467161323
Provider Name (Legal Business Name): ELIZABETH INEZ SILVA LMSW, LSWAIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2022
Last Update Date: 11/21/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 W BELL ST STE B
SEQUIM WA
98382-2916
US

IV. Provider business mailing address

435 W BELL ST STE B
SEQUIM WA
98382-2916
US

V. Phone/Fax

Practice location:
  • Phone: 365-207-4345
  • Fax: 360-362-8202
Mailing address:
  • Phone: 365-207-4345
  • Fax: 360-362-8202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number56773
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSC61256480
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: