Provider Demographics
NPI:1174271647
Name:RAWLS, ELIZABETH ANN (ATC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:RAWLS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 144
Mailing Address - Street 2:
Mailing Address - City:GARFIELD
Mailing Address - State:WA
Mailing Address - Zip Code:99130-0144
Mailing Address - Country:US
Mailing Address - Phone:509-592-8742
Mailing Address - Fax:
Practice Address - Street 1:1ST AND MCCOY ST
Practice Address - Street 2:
Practice Address - City:OAKESDALE
Practice Address - State:WA
Practice Address - Zip Code:99130
Practice Address - Country:US
Practice Address - Phone:509-592-8742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer