Individual
ELIZABETH K. GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
3210 200TH PL SW, LYNNWOOD, WA 98036-6934
(425) 353-5656
Mailing address
3210 200TH PL SW, LYNNWOOD, WA 98036-6934
(425) 353-5656
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT00001585
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23929U
REGENCE BLUE SHIELD PIN
WA
Enumeration date
08/10/2006
Last updated
10/24/2016
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