Active NPI
Elizabeth Marie Allen-Racicot, L.M.P.
- Specialist
- Clarkston, WA
National Provider Identifier
1649429317
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- MA00022912
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| MA00022912 | WA | MD | Specialist |
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.