Provider Demographics
NPI:1538309125
Name:MILO, ELIZABETH ANNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANNE
Last Name:MILO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ZANNY
Other - Middle Name:
Other - Last Name:MILO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1020 E JOHN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5740
Mailing Address - Country:US
Mailing Address - Phone:206-522-2606
Mailing Address - Fax:
Practice Address - Street 1:1020 E JOHN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5740
Practice Address - Country:US
Practice Address - Phone:206-522-2606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-23
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002526103T00000X
103TB0200X, 103TC2200X, 103TF0000X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPY00002526OtherWASHINGTON STATE DEPARTMENT OF HEALTH, PSYCHOLOGIST LICENSE