Boden, Elisa K

Boden, Elisa K is an sole proprietor health care provider with primary practice located at 1100 9Th Ave Buck Pavillion 3Rd Floor, Seattle WA 98101-2756. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is her primary health care specialty. Boden, Elisa K can be contacted via phone (206) 223-2319.

Contact Information

Primary practice address
1100 9Th Ave Buck Pavillion 3Rd Floor Seattle WA 98101-2756
Phone: (206) 223-2319
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 226232 Massachusetts
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD 60229173 Washington
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 60 256098 New York
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD201931 Oregon

Profile Details

NPI number 1932167400
LBN Legal business name Boden, Elisa K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 3rd, 2006
Last updated Jun 7th, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932167400 NPPES
Washington Other 1932167400 MONTANA DSHS
Washington Other 0284291 MONTANA DSHS
Washington MEDICAID 1932167400 MONTANA DSHS

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