Healthcare Provider Details

I. General information

NPI: 1184870396
Provider Name (Legal Business Name): ELAINE Y TSAO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 11/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE DEPARTMENT OF REHABILITATION MEDICINE
SEATTLE WA
98105
US

IV. Provider business mailing address

PO BOX 5371 MS OB.8.410
SEATTLE WA
98145-5005
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2114
  • Fax:
Mailing address:
  • Phone: 206-987-2114
  • Fax: 206-987-2651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License NumberMD 60465651
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: