Provider Demographics
NPI:1720392459
Name:FERNANDEZ PAYNE, ELIS MABEL (WHNP-BC)
Entity type:Individual
Prefix:MS
First Name:ELIS
Middle Name:MABEL
Last Name:FERNANDEZ PAYNE
Suffix:
Gender:F
Credentials:WHNP-BC
Other - Prefix:
Other - First Name:ELIS
Other - Middle Name:M
Other - Last Name:SALAMONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP-BC
Mailing Address - Street 1:450 ALASKAN WAY S STE 200
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2785
Mailing Address - Country:US
Mailing Address - Phone:888-731-8994
Mailing Address - Fax:
Practice Address - Street 1:450 ALASKAN WAY S STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2785
Practice Address - Country:US
Practice Address - Phone:888-731-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-05
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001129600163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory