Individual provider · Type 1 NPI

Ethan Michael Elizondo, DDS

Student in an Organized Health Care Education/Training Program · Seattle, WA

NPI number 1679288104 Active

Practice location

4915 25th Ave NE
Seattle, WA 98105-5667

Call (206) 524-1600 Map

Fax (206) 524-1603

Mailing address

223 Circle Dr
Corpus Christi, TX 78411-1232

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1679288104

Ethan Michael Elizondo, DDS's National Provider Identifier is 1679288104, issued on Jan 19, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Seattle, WA. The record was last updated on Jan 19, 2023.