Healthcare Provider Details

I. General information

NPI: 1033045109
Provider Name (Legal Business Name): ELSA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6047 NE 203RD ST
KENMORE WA
98028-8530
US

IV. Provider business mailing address

6047 NE 203RD ST
KENMORE WA
98028-8530
US

V. Phone/Fax

Practice location:
  • Phone: 206-816-5252
  • Fax: 206-816-5252
Mailing address:
  • Phone: 206-816-5252
  • Fax: 425-984-0263

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH ELIZABETH
Title or Position: OWNER
Credential: ABEBE
Phone: 206-816-5252