MEDICARE: MS. ELIZABETH NEILSON

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	104100000X	Social Worker
2	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1982816278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH NEILSON

Provider Business Mailing Address
First Line	:	119A GUTHRIE HALL
Second Line	:	BOX 351525
City	:	SEATTLE
State	:	WA
Zip	:	98195
Country	:	US
Telephone Number	:	313-408-2928
Fax Number	:

Provider Business Practice Location Address
First Line	:	3917 UNIVERSITY WAY NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-6613
Country	:	US
Telephone Number	:	206-543-6511
Fax Number	:

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	05/08/2018

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