Basic Information
| Provider Information | |||||||||
| NPI: | 1811932460 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TING | ||||||||
| FirstName: | ELISABETH | ||||||||
| MiddleName: | KARTIKA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 505 S 336TH ST | ||||||||
| Address2: | SUITE 600 | ||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980036328 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538386180 | ||||||||
| FaxNumber: | 2538386418 | ||||||||
| Practice Location | |||||||||
| Address1: | 10631 8TH AVE NE | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981257213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063642050 | ||||||||
| FaxNumber: | 2063615722 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2006 | ||||||||
| LastUpdateDate: | 06/26/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD00045582 | WA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0212578 | 01 | WA | LIWA | OTHER | IJO1979 | 01 | WA | OTHER | OTHER | 0212577 | 01 | WA | LIWA | OTHER | 4635IJ | 01 | WA | BSWA | OTHER | 8462772 | 05 | WA | MEDICAID | 3984IJ | 01 | WA | BSWA | OTHER |