Provider Demographics
NPI:1184038721
Name:RIPLEY, ELIZABETH A (AUD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:RIPLEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 8TH AVE NE STE 310
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-5436
Mailing Address - Country:US
Mailing Address - Phone:425-454-3938
Mailing Address - Fax:425-392-3561
Practice Address - Street 1:510 8TH AVE NE STE 310
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029
Practice Address - Country:US
Practice Address - Phone:425-454-3938
Practice Address - Fax:425-392-3561
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2019-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2251231H00000X
WALD60924963231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2121728Medicaid