Individual
ELIZABETH NEUHALFEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1007 39TH AVE SE, PUYALLUP, WA 98374-2192
(253) 445-7100
Mailing address
1007 39TH AVE SE, PUYALLUP, WA 98374-2192
(253) 445-7100
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00035122
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0184285
L & I PROVIDER NUMBER
WA
01
—
5350520
AETNA PROVIDER NUMBER
WA
05
—
8209462
—
WA
01
—
911203494BK
KPS PROVIDER NUMBER
WA
01
—
98328A003
TRICARE PROVIDER NUMBER
WA
01
—
NE1084
REGENCE RIDER NUMBER
WA
Enumeration date
06/13/2006
Last updated
04/27/2021
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