Provider Demographics
NPI:1396356432
Name:PEDRAZA DE LOWE, ELIZABET
Entity Type:Individual
Prefix:
First Name:ELIZABET
Middle Name:
Last Name:PEDRAZA DE LOWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABET
Other - Middle Name:
Other - Last Name:PEDRAZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5608 JAMES ST SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98513-4180
Mailing Address - Country:US
Mailing Address - Phone:360-556-3854
Mailing Address - Fax:
Practice Address - Street 1:5608 JAMES ST SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98513-4180
Practice Address - Country:US
Practice Address - Phone:360-556-3854
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC15931171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMC15931OtherCERTIFIED MEDICAL INTERPRETER