Individual
ELIZABETH FORMAN SERDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
200 LILLY RD NE STE C, OLYMPIA, WA 98506-5080
(360) 918-8336
(360) 972-2152
Mailing address
200 LILLY RD NE STE C, OLYMPIA, WA 98506-5080
(360) 481-7788
(360) 972-2152
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP 60301000
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
AP60301000
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2025519
—
WA
01
—
304788
L & I WA
WA
Enumeration date
08/13/2012
Last updated
12/21/2022
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