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Individual

ELISHA NZIENGUI BOUSSENGUI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
314 NE THORNTON PL, SEATTLE, WA 98125-9000
(206) 520-2350
(206) 520-2399
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60302743
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1639493513
WA
Enumeration date
03/20/2010
Last updated
10/08/2020
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