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MARYANN ELIZABETH IVERSEN SUDPT
NPI 1467193458
Student in an Organized Health Care Education/Training Program in Federal Way, WA

Active since April 05, 2022
30620 PACIFIC HWY S STE 107, FEDERAL WAY, WA 98003(253) 941-7555 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Maryann Elizabeth Iversen Sudpt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYANN ELIZABETH IVERSEN SUDPT (NPI 1467193458) is an individual student in an organized health care education/training program in Federal Way, Washington, licensed in Washington (CO61285882) and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1467193458
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameMARYANN ELIZABETH IVERSENCredential: SUDPT
Location Address30620 PACIFIC HWY S STE 107Federal Way, WA 98003-4888
Mailing Address30620 Pacific Hwy S Ste 107Federal Way, WA 98003-4888 · (253) 941-7555 · Fax (253) 941-0652
Phone(253) 941-7555
Sole ProprietorNo
Enumeration DateApril 5, 2022
NPPES CertifiedApril 4, 2022
✔ NPI 1467193458 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in WA · CO61285882
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
30620 PACIFIC HWY S STE 107, Federal Way, WA 98003
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Other Names 1

Former Name (1)Maryann Elizabeth Lillie

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANNE ELIZABETH NEARN CDP
Counselor (Addiction (Substance Use Disorder))
30620 PACIFIC HWY S STE 107
FEDERAL WAY, WA 98003
King County (253) 941-7555
JACK ALLEN WESSON CDP
Counselor (Addiction (Substance Use Disorder))
30620 PACIFIC HWY S STE 107
FEDERAL WAY, WA 98003
King County (253) 941-7555
EILEEN GWENDOLYN PETRIE CDPT
Student in an Organized Health Care Education/Training Program
30620 PACIFIC HWY S STE 107
FEDERAL WAY, WA 98003
King County (253) 941-7555
CRISTY JUNE MUNOZ CDP
Counselor (Addiction (Substance Use Disorder))
30620 PACIFIC HWY S STE 107
FEDERAL WAY, WA 98003
King County (253) 941-7555
GINA RAE MARTINEZ CDP
Counselor (Addiction (Substance Use Disorder))
30620 PACIFIC HWY S STE 107
FEDERAL WAY, WA 98003
King County (253) 941-7555
RAYMOND GATES
Counselor (Addiction (Substance Use Disorder))
30620 PACIFIC HWY S STE 107
FEDERAL WAY, WA 98003
King County (253) 941-7555

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maryann Iversen's NPI number?

The NPI number for Maryann Iversen is 1467193458. It was assigned to this individual provider in the NPPES registry on April 5, 2022. The provider is also known as Maryann Elizabeth Lillie.

Where is Maryann Iversen located?

Maryann Iversen practices at 30620 Pacific Hwy S Ste 107, Federal Way, WA 98003. The listed phone number is (253) 941-7555.

What is Maryann Iversen's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Maryann Iversen was last updated on April 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.