Healthcare Provider Details

I. General information

NPI: 1457239139
Provider Name (Legal Business Name): ELIZABETH ALINE BABCOCK PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16528 E DESMET CT STE 1600
SPOKANE VALLEY WA
99216-3522
US

IV. Provider business mailing address

PO BOX 31001-4114
PASADENA CA
91110-0001
US

V. Phone/Fax

Practice location:
  • Phone: 509-944-8907
  • Fax: 509-508-4552
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-944-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA70049168
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: