Provider Demographics
NPI:1861234940
Name:PARUCHURU, ELIZABETH (LSWAIC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PARUCHURU
Suffix:
Gender:F
Credentials:LSWAIC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:GERAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:11415 NE 128TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-6314
Mailing Address - Country:US
Mailing Address - Phone:425-298-7638
Mailing Address - Fax:
Practice Address - Street 1:11415 NE 128TH ST STE 100
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6314
Practice Address - Country:US
Practice Address - Phone:425-298-7638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC609356911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical