Healthcare Provider Details

I. General information

NPI: 1356694681
Provider Name (Legal Business Name): PAULINA ELLIOTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

830 SW 116TH ST
SEATTLE WA
98146-2257
US

IV. Provider business mailing address

830 SW 116TH ST
SEATTLE WA
98146-2257
US

V. Phone/Fax

Practice location:
  • Phone: 206-631-6229
  • Fax: 206-631-6162
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN 00120937
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: