Provider Demographics
NPI:1740531615
Name:STEWART, ELIZABETH CALEY (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:CALEY
Last Name:STEWART
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8604 SE SHERLEY AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-2672
Mailing Address - Country:US
Mailing Address - Phone:360-607-0861
Mailing Address - Fax:
Practice Address - Street 1:2214 E 13TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-4120
Practice Address - Country:US
Practice Address - Phone:360-696-6321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200541995RN163W00000X
WARN00162246163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse