Provider Demographics
NPI:1588750004
Name:VIG, ELIZABETH KAREN (MD MPH)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:KAREN
Last Name:VIG
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1660 S COLUMBIAN WAY VAPSHCS
Mailing Address - Street 2:S182 ETHICS
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108
Mailing Address - Country:US
Mailing Address - Phone:206-764-2308
Mailing Address - Fax:206-277-4405
Practice Address - Street 1:1660 S COLUMBIAN WAY VAPSHCS
Practice Address - Street 2:S182 ETHICS
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108
Practice Address - Country:US
Practice Address - Phone:206-764-2308
Practice Address - Fax:206-277-4405
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00034003207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8245987Medicaid
WA8245987Medicaid
WAG95700Medicare UPIN