Provider Demographics
NPI:1598254898
Name:DEYO, ELIZABETH BELEN (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BELEN
Last Name:DEYO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 14TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-4807
Mailing Address - Country:US
Mailing Address - Phone:206-762-3730
Mailing Address - Fax:
Practice Address - Street 1:310 15TH AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5103
Practice Address - Country:US
Practice Address - Phone:206-326-3000
Practice Address - Fax:877-515-2975
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61200053207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine