Healthcare Provider Details

I. General information

NPI: 1902437536
Provider Name (Legal Business Name): CLARA ELISABETH HELENE LIBBRECHT MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2020
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 SAND POINT WAY NE
SEATTLE WA
98105-3901
US

IV. Provider business mailing address

735 BROADWAY E UNIT 202
SEATTLE WA
98102-6072
US

V. Phone/Fax

Practice location:
  • Phone: 206-987-2106
  • Fax:
Mailing address:
  • Phone: 720-660-1857
  • 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 Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberMD61261131
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD61261131
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: