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General NPI Number Information
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NPI Number | 1104442672
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Entity Type | Individual
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Provider Name | ELIZABETH FAY LM, CPM
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Gender | Female
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 11/25/2022
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Provider Practice Location Address
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Address Line | 402 S 333RD ST STE 104
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7099
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Country | US
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Telephone | 925-324-0892
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Fax |
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Provider Business Mailing Address
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Address Line | 34617 11TH PL S STE 201
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City | FEDERAL WAY
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State | WA
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Zip | 98003-8706
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Country | US
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Telephone | 253-313-1031
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Fax | 253-393-5443
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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