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Individual

ELIZABETH NELL MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1812 S MILDRED ST STE H, TACOMA, WA 98465-1634
(253) 301-5270
Mailing address
6519 55TH STREET CT W, UNIVERSITY PLACE, WA 98467-2968
(425) 681-8676

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61059965
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
60582180
RN LICENSE
WA
01
61059965
WA ARNP CREDENTIAL
WA
01
F01201277
AANP FNP CERTIFICATION
Enumeration date
07/02/2020
Last updated
09/02/2020
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