Provider Demographics
NPI:1912215385
Name:BUSTO, ELENA (RN)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:BUSTO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6020 35TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3002
Mailing Address - Country:US
Mailing Address - Phone:206-461-6950
Mailing Address - Fax:206-461-8542
Practice Address - Street 1:905 SPRUCE ST
Practice Address - Street 2:STE 300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2474
Practice Address - Country:US
Practice Address - Phone:206-548-3012
Practice Address - Fax:206-461-8382
Is Sole Proprietor?:No
Enumeration Date:2010-09-20
Last Update Date:2010-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60095421163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse