Provider Demographics
NPI:1972689727
Name:HIGANO, CELESTIA S (MD)
Entity Type:Individual
Prefix:
First Name:CELESTIA
Middle Name:S
Last Name:HIGANO
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 1:3515 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5268
Mailing Address - Country:US
Mailing Address - Phone:206-972-7952
Mailing Address - Fax:206-329-7316
Practice Address - Street 1:3515 E SPRING ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-5268
Practice Address - Country:US
Practice Address - Phone:206-972-7952
Practice Address - Fax:206-329-7316
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00019850207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8115487Medicaid
5909OtherINTERNAL ID-MOTOR VEHICLE ID
5909OtherINTERNAL ID-MOTOR VEHICLE ID
E32562Medicare UPIN