Provider Demographics
NPI:1306957592
Name:CHUANG, ELAINE LUCILLE (MD)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:LUCILLE
Last Name:CHUANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1805 12TH AVE W
Mailing Address - Street 2:UNIT C
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2978
Mailing Address - Country:US
Mailing Address - Phone:206-283-9452
Mailing Address - Fax:
Practice Address - Street 1:U WASHINGTON DEPT OF OPHTHALMOLOGY
Practice Address - Street 2:BOX 356485
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-543-7687
Practice Address - Fax:206-543-4414
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAWA 025209 / 18731207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAD50486Medicare UPIN