MEDICARE: SIERRA LYNN EZRRE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1104782333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA LYNN EZRRE

Provider Business Mailing Address
First Line	:	8421 DECOY BLVD
Second Line	:
City	:	JUNEAU
State	:	AK
Zip	:	99801-8959
Country	:	US
Telephone Number	:	907-209-2658
Fax Number	:

Provider Business Practice Location Address
First Line	:	1412 SW 43RD ST STE 140
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98057-4803
Country	:	US
Telephone Number	:	425-264-0750
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2025
Last Update Date	:	12/31/2025

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Directions to “ SIERRA LYNN EZRRE ” Practice Location

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