Provider Demographics
NPI:1669461596
Name:REPASS, ELIZABETH BROOKE (SCM)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:BROOKE
Last Name:REPASS
Suffix:
Gender:F
Credentials:SCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1135 116TH AVE NE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4623
Mailing Address - Country:US
Mailing Address - Phone:425-990-6254
Mailing Address - Fax:425-688-8110
Practice Address - Street 1:1135 116TH AVE NE
Practice Address - Street 2:SUITE 320
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4623
Practice Address - Country:US
Practice Address - Phone:425-990-6254
Practice Address - Fax:425-688-8110
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS