Provider Demographics
NPI:1790819704
Name:GEORGE, ELIZABETH ROPER DODDS (LMP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ROPER DODDS
Last Name:GEORGE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:GEORGE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMP
Mailing Address - Street 1:14304 23RD PL NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3331
Mailing Address - Country:US
Mailing Address - Phone:206-440-8300
Mailing Address - Fax:
Practice Address - Street 1:9500 ROOSEVELT WAY NE
Practice Address - Street 2:SUITE 210
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2252
Practice Address - Country:US
Practice Address - Phone:206-748-1556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00010736225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist