Tanaka, Elisa Mari

Tanaka, Elisa Mari is an individual health care provider with primary practice located at 14700 28Th Ave N Ste 20 , Minneapolis MN 55447-4876. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Anesthesiology. Allopathic & Osteopathic Physicians / Anesthesiology is her primary health care specialty. Tanaka, Elisa Mari can be contacted via phone (763) 852-0411.

Contact Information

Primary practice address
14700 28Th Ave N Ste 20 Minneapolis MN 55447-4876
Phone: (763) 852-0411
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 53903 Minnesota

Profile Details

NPI number 1235305483
LBN Legal business name Tanaka, Elisa Mari
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2008
Last updated Dec 29th, 2021 - about 3 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 1235305483 NPPES
Minnesota Other 20394 RESIDENT PERMIT

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