Individual provider Active NPI

Elizabeth Marie Allen-Racicot, L.M.P.

  • Specialist
  • Clarkston, WA
National Provider Identifier
1649429317
Registry record updated Sep 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA00022912 Issued in WA
Practice address
1013 Bridge Street
Clarkston, WA 99403
Phone
(509) 751-9377
NPI assigned
Sep 17, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA00022912 WA Primary

Addresses

Primary practice location

1013 Bridge Street
Clarkston, WA 99403

Mailing address

731 Burnell Ave.
Lewiston, ID 83501-4985
Phone (208) 798-3215

Other names 1

  • Ms. Elizabeth Marie Allen Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA00022912WAMDSpecialist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221609600000",
    "number": "1649429317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 BURNELL AVE.",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014985",
            "telephone_number": "208-798-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1013 BRIDGE STREET",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "99403",
            "telephone_number": "509-751-9377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN-RACICOT",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "L.M.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-17",
        "last_updated": "2008-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "MA00022912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ALLEN",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "L.M.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarkston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.