Provider Demographics
NPI:1376421057
Name:WILLETT-CAOAGDAN, ELANA RAGINE
Entity type:Individual
Prefix:
First Name:ELANA
Middle Name:RAGINE
Last Name:WILLETT-CAOAGDAN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 S EDDY ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-3136
Mailing Address - Country:US
Mailing Address - Phone:206-709-4006
Mailing Address - Fax:
Practice Address - Street 1:3800 S EDDY ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-3136
Practice Address - Country:US
Practice Address - Phone:206-709-4006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA70025574225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist