Provider Demographics
NPI:1093817991
Name:SAWYER SCOVEL, ELIZABETH A (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:A
Last Name:SAWYER SCOVEL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-2663
Mailing Address - Country:US
Mailing Address - Phone:360-574-9565
Mailing Address - Fax:360-574-9685
Practice Address - Street 1:2400 MAIN ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2663
Practice Address - Country:US
Practice Address - Phone:360-574-9565
Practice Address - Fax:360-574-9685
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY2986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8387185Medicaid
WAP000240090Medicare ID - Type UnspecifiedRAILROAD MEDICARE
WAG8855282Medicare ID - Type Unspecified
WA300356601OtherBLUE CROSS/BLUE SHIELD
WAP000240090Medicare ID - Type UnspecifiedRAILROAD MEDICARE