MEDICARE: ELIZABETH H SIEGEL ARNP

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	363LF0000X	Family Nurse Practitioner	AP30001895	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295887461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH H SIEGEL ARNP

Provider Business Mailing Address
First Line	:	4816 SHE NAH NUM DR SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98513-9105
Country	:	US
Telephone Number	:	360-459-5312
Fax Number	:	360-456-1557

Provider Business Practice Location Address
First Line	:	4816 SHE NAH NUM DR SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98513-9105
Country	:	US
Telephone Number	:	360-459-5312
Fax Number	:	360-456-1557

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	12/05/2011

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