Individual
ELIZABETH ANNE PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2499
(206) 744-3000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00033750
WA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD00033750
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4769
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8263964
—
WA
01
—
930096000
RAIL ROAD MEDICARE
WA
Enumeration date
10/27/2006
Last updated
01/05/2012
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