Provider Demographics
NPI:1518434687
Name:HYDE, ELIZABETH MEYERS
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:MEYERS
Last Name:HYDE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3011 ROCKY POINT RD NW
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-1918
Mailing Address - Country:US
Mailing Address - Phone:360-813-4261
Mailing Address - Fax:
Practice Address - Street 1:3011 ROCKY POINT RD NW
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98312-1918
Practice Address - Country:US
Practice Address - Phone:360-813-4261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA529103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool