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NPI Code Detail

MEDICARE: MS. ELIZABETH ANNA MIZE B.S., LMP

MEDICARE: MS. ELIZABETH ANNA MIZE B.S., LMP
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
1172M00000XMechanotherapistMA00017624WA

General Provider Information

NPI Number : 1306052535
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELIZABETH ANNA MIZE B.S., LMP
Provider Business Mailing Address
First Line : 7153 FAUNTLEROY WAY SW
Second Line :
City : SEATTLE
State : WA
Zip : 98136-2008
Country : US
Telephone Number : 206-713-0775
Fax Number :
Provider Business Practice Location Address
First Line : 7153 FAUNTLEROY WAY SW
Second Line :
City : SEATTLE
State : WA
Zip : 98136-2008
Country : US
Telephone Number : 206-713-0775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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