# CARENA MEDICAL PROVIDERS PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Elliott Bay Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1902935711
- **Authorized official:** MRS. JULIE MARIA SMITH (CLINIC MANAGER)
- **Authorized official phone:** (206) 838-6856

## Contact information

- **Practice address:** 999 3RD AVE, SUITE 680, SEATTLE, WA 98104-4019
- **Practice address phone:** (206) 838-6856
- **Practice address fax:** (206) 838-3085
- **Mailing address:** 999 3RD AVE, SUITE 680, SEATTLE, WA 98104-4019
- **Mailing address phone:** (206) 838-6856
- **Mailing address fax:** (206) 838-3085

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 261Q00000X | Clinic/Center | 602476731 | WA | — |

## Other

- **Enumeration date:** 03/05/2007
- **Last updated:** 02/06/2015