Provider Demographics
NPI:1043356157
Name:WILLIAMS, ELIZABETH ANN (NP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10203 GIG HARBOR DR NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-7547
Mailing Address - Country:US
Mailing Address - Phone:253-851-3735
Mailing Address - Fax:
Practice Address - Street 1:1802 YAKIMA AVE
Practice Address - Street 2:SUITE 102A
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4499
Practice Address - Country:US
Practice Address - Phone:253-426-4146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006578363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0195658OtherL&I
WAP00317527OtherRAILROAD
WA910564491-AAOtherKPS
WA9644980Medicaid
WA7710WIOtherREGENCE
WA8905950OtherCRIME VICTIMS
WA8905950OtherCRIME VICTIMS