Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 176B00000X | Midwife |
NPI | 1104442672 |
---|---|
Provider Name | Elizabeth Fay |
First Address | Seattle, WA 98144-3405 |
Second Address | Federal Way, WA 98003-7099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2020 |
Last Update Date | 16/11/2020 |