1558332577 NPI number — DR. ELLEN Y AHANA PHD

Table of content: DR. ELLEN Y AHANA PHD (NPI 1558332577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558332577 NPI number — DR. ELLEN Y AHANA PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AHANA
Provider First Name:
ELLEN
Provider Middle Name:
Y
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BOHRER
Provider Other First Name:
ELLEN
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1558332577
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8001 SAND POINT WAY NE
Provider Second Line Business Mailing Address:
C65
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98115-8112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-420-3734
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14042 NE 8TH ST #201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVUE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98007-4142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-746-3782
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  426 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)