Provider Demographics
NPI:1225008337
Name:ELGIN, ELAINE ROBBIN
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:ROBBIN
Last Name:ELGIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20307 28TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6915
Mailing Address - Country:US
Mailing Address - Phone:425-776-3526
Mailing Address - Fax:
Practice Address - Street 1:22803 44TH AVE W
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-5032
Practice Address - Country:US
Practice Address - Phone:425-771-3738
Practice Address - Fax:425-776-1190
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00040020183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician