Provider Demographics
NPI:1881847895
Name:GAYLORD, ELIZABETH R (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:GAYLORD
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUITE #4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:2075 BARKLEY BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6614
Practice Address - Country:US
Practice Address - Phone:360-671-3345
Practice Address - Fax:360-650-1354
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60058351363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA243434OtherL&I
WA8949682OtherL & I CRIME VICTIMS
WA3976GAOtherREGENCE
WA9659723Medicaid
WA3976GAOtherREGENCE