Provider Demographics
NPI:1417360256
Name:PEANG, ELIZABETH TEPILEAKHENA (CASE MANAGER)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TEPILEAKHENA
Last Name:PEANG
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:TEPILEAKHENA
Other - Last Name:PEANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6400 SOUTHCENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2547
Mailing Address - Country:US
Mailing Address - Phone:206-902-2000
Mailing Address - Fax:
Practice Address - Street 1:6400 SOUTHCENTER BLVD
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2547
Practice Address - Country:US
Practice Address - Phone:206-902-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program