Provider Demographics
NPI:1952365140
Name:HUGHES, ELIZABETH CHANDLER (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CHANDLER
Last Name:HUGHES
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 1:626 120TH AVE NE
Mailing Address - Street 2:STE B104
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-3077
Mailing Address - Country:US
Mailing Address - Phone:206-505-1000
Mailing Address - Fax:
Practice Address - Street 1:626 120TH AVE NE
Practice Address - Street 2:STE B104
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3077
Practice Address - Country:US
Practice Address - Phone:206-505-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00044346207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8471831Medicaid
WA8863500Medicare PIN
WAG8880562Medicare PIN
WA8471831Medicaid
WAG8880561Medicare PIN