Healthcare Provider Details

I. General information

NPI: 1164661427
Provider Name (Legal Business Name): COLLEEN ELIZABETH ANNESLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2009
Last Update Date: 01/16/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SEATTLE CHILDREN'S HOSPITAL 4800 SAND POINT WAY NE
SEATTLE WA
98105
US

IV. Provider business mailing address

SEATTLE CHILDREN'S HOSPITAL 4800 SAND POINT WAY NE
SEATTLE WA
98105
US

V. Phone/Fax

Practice location:
  • Phone: 62-987-2000
  • Fax: 206-987-3946
Mailing address:
  • Phone: 62-987-2000
  • Fax: 206-987-3946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberTRN10518
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberD0068566
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0068566
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: