Provider Demographics
NPI:1457678856
Name:FREEMAN, ELIZABETH CAROLINE (LMP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CAROLINE
Last Name:FREEMAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 HYLEBOS AVE
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:WA
Mailing Address - Zip Code:98354-9729
Mailing Address - Country:US
Mailing Address - Phone:253-640-8552
Mailing Address - Fax:
Practice Address - Street 1:29 HYLEBOS AVE
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:WA
Practice Address - Zip Code:98354-9729
Practice Address - Country:US
Practice Address - Phone:253-640-8552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60141179172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist