Provider Demographics
NPI:1245270586
Name:NIERMAN, ELIZABETH R (PT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:NIERMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 SUMMERCREEK PL.
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:509-665-3120
Mailing Address - Fax:
Practice Address - Street 1:203 MISSION ST.
Practice Address - Street 2:SUITE 112
Practice Address - City:CASHMERE
Practice Address - State:WA
Practice Address - Zip Code:98815
Practice Address - Country:US
Practice Address - Phone:509-782-8818
Practice Address - Fax:509-782-8919
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00006458174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB33642Medicare ID - Type UnspecifiedGRP.#AB33641