Provider Demographics
NPI:1710902275
Name:LYTER, ELIZABETH ANN (DPT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:LYTER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:KUIPERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:PO BOX 5299
Mailing Address - Street 2:MS: 737-3-PCON
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0299
Mailing Address - Country:US
Mailing Address - Phone:206-853-2724
Mailing Address - Fax:
Practice Address - Street 1:702 S HILL PARK DR
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-1426
Practice Address - Country:US
Practice Address - Phone:253-604-4953
Practice Address - Fax:253-604-4956
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00008900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA912075994OtherKITSAP PHYSCIAL THERAPY &
WA8340879Medicaid
WA0162829OtherL & I
WA912075994OtherKITSAP PHYSCIAL THERAPY &