Provider Demographics
NPI:1659373249
Name:MIZGALA, LIANE M (MD)
Entity Type:Individual
Prefix:DR
First Name:LIANE
Middle Name:M
Last Name:MIZGALA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:933 RED APPLE RD STE D
Mailing Address - Street 2:CENTRAL WASHINGTON HOSPITAL WOMEN'S HEALTHCARE CENTER
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3370
Mailing Address - Country:US
Mailing Address - Phone:509-665-6125
Mailing Address - Fax:509-665-6124
Practice Address - Street 1:933 RED APPLE RD STE D
Practice Address - Street 2:CENTRAL WASHINGTON HOSPITAL WOMEN'S HEALTHCARE CENTER
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3370
Practice Address - Country:US
Practice Address - Phone:509-665-6125
Practice Address - Fax:509-665-6124
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2010-09-08
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Provider Licenses
StateLicense IDTaxonomies
WAMD00035444207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8212854Medicaid
WAG60036Medicare UPIN
WAG8891976Medicare PIN