Provider Demographics
NPI:1558332577
Name:AHANA, ELLEN Y (PHD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:Y
Last Name:AHANA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:A
Other - Last Name:BOHRER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8001 SAND POINT WAY NE
Mailing Address - Street 2:C65
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8112
Mailing Address - Country:US
Mailing Address - Phone:206-420-3734
Mailing Address - Fax:
Practice Address - Street 1:14042 NE 8TH ST #201
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-4142
Practice Address - Country:US
Practice Address - Phone:425-746-3782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-28
Last Update Date:2009-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA426103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
G000108322Medicare PIN