Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | AP60974090 | WA |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP60974090 | WA |
NPI | 1093367005 |
---|---|
Provider Name | Elizabeth Anne Yeater |
First Address | Port Townsend, WA 98368-2443 |
Second Address | Port Townsend, WA 98368-2443 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2019 |
Last Update Date | 18/09/2019 |