MEDICARE: AUBRY ELIZABETH ESPINOSA RCIS

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	2471C1106X	Cardiac-Interventional Technology Radiologic Technologist

General Provider Information

NPI Number	:	1508314840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AUBRY ELIZABETH ESPINOSA RCIS

Provider Business Mailing Address
First Line	:	4409 S ESPANOLA RD
Second Line	:
City	:	MEDICAL LAKE
State	:	WA
Zip	:	99022-8638
Country	:	US
Telephone Number	:	808-954-5616
Fax Number	:

Provider Business Practice Location Address
First Line	:	4409 S ESPANOLA RD
Second Line	:
City	:	MEDICAL LAKE
State	:	WA
Zip	:	99022-8638
Country	:	US
Telephone Number	:	808-954-5616
Fax Number	:

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

Provider Enumeration Date	:	09/15/2016
Last Update Date	:	09/15/2016

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