MEDICARE: ELIZABETH DANA MEYER MA

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	106H00000X	Marriage & Family Therapist	MG60283254	WA

General Provider Information

NPI Number	:	1528319142
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH DANA MEYER MA

Provider Business Mailing Address
First Line	:	14201 SE PETROVITSKY RD STE A3
Second Line	:
City	:	RENTON
State	:	WA
Zip	:	98058-8986
Country	:	US
Telephone Number	:	206-853-7976
Fax Number	:

Provider Business Practice Location Address
First Line	:	4618 S CHICAGO ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-4114
Country	:	US
Telephone Number	:	206-853-7976
Fax Number	:

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

Provider Enumeration Date	:	09/21/2012
Last Update Date	:	08/02/2023

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