Provider Demographics
NPI:1184716649
Name:EINSET, ELIZABETH (CPO)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:EINSET
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7561
Mailing Address - Street 2:
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901-2561
Mailing Address - Country:US
Mailing Address - Phone:907-254-1276
Mailing Address - Fax:907-247-7868
Practice Address - Street 1:5193 BORCH ST N
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-9036
Practice Address - Country:US
Practice Address - Phone:907-254-1276
Practice Address - Fax:907-247-7868
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK4406980001Medicare NSC