Healthcare Provider Details

I. General information

NPI: 1649665829
Provider Name (Legal Business Name): ELIZABETH ABERNATHEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2015
Last Update Date: 08/07/2024
Certification Date: 08/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4540 SAND POINT WAY NE
SEATTLE WA
98105-3941
US

IV. Provider business mailing address

MS: CBS-200 PO BOX 5371
SEATTLE WA
98145
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-4414
  • Fax:
Mailing address:
  • Phone: 206-987-4414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60869836
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number60869836
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: