Healthcare Provider Details

I. General information

NPI: 1235870304
Provider Name (Legal Business Name): ELLEN BRINZA MD, MPH, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST
SEATTLE WA
98195-6422
US

IV. Provider business mailing address

1959 NE PACIFIC ST
SEATTLE WA
98195-6422
US

V. Phone/Fax

Practice location:
  • Phone: 206-685-1397
  • Fax:
Mailing address:
  • Phone: 206-685-1397
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD.MD.70124556
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDR.75444
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: