ELLEN LYMAN THOMASON DERRICK (NPI# 1659480630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659480630 |
| Entity Type | Individual |
| Full Name | ELLEN LYMAN THOMASON DERRICK |
| Other Name | ELLEN L THOMASON |
| Credential | MD |
| Practice Address |
3216 Ne 45th Pl Ste 207 Seattle WA 98105-4028 |
| Mailing Address |
6541 50th Ave Ne Seattle WA 98115 |
| Practice Telephone | 2065963976 |
| Practice Fax Number | 2064869013 |
| Mailing Telephone | (206) 818-6905 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2017-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD00045873 | WA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1659480630 | 05 |
| Street Address |
3216 NE 45TH PL STE 207 |
| City | SEATTLE |
| State | WA |
| Zip Code | 98105-4028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841712072 | Boxbar Consulting Pllc | Surgery | 3216 Ne 45th Pl Ste 207, Seattle, WA 98105-4028 | 2017-07-10 |
| 1902335805 | Derrick Consulting Pllc | Anesthesiology | 3216 Ne 45th Pl Ste 207, Seattle, WA 98105-4028 | 2017-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326662396 | Dale Justin Podolsky | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Ob.9.520, Seattle Children's, Seattle, WA 98105 | 2020-06-04 |
| 1376170878 | Andrew Crompton Yazman | Pediatrics | 4800 Sand Point Way, Ne Oc.7.830, Seattle, WA 98105 | 2020-03-25 |
| 1427688845 | Daniela Michell Zepeda | Behavioral Analyst | 4616 25th Ave Ne Pmb 437, Seattle, WA 98105 | 2020-01-24 |
| 1255981189 | Emily King | Student in an Organized Health Care Education/Training Program | Mark Hawkins, Pa-c, Mpas, 4311 11th Ave Ne Suite 200, WA 98105 | 2019-09-12 |
| 1821659327 | Sara Katherine Horne | Student in an Organized Health Care Education/Training Program | 4800 Sand Point Way Ne, Mb.11.500, Department of Anesthesiology and Pain Medicine, Seattle, Seattle, WA 98105 | 2019-06-25 |
| 1881252575 | Darryl Lee Wright | Peer Specialist | Gossett Place, 4719 12th Ave Ne, Seattle, WA 98105 | 2019-05-29 |
| 1487117891 | Nirupama Madhavan | Behavioral Analyst | 5001 25th Ave Ne, Seattle, WA 98105 | 2019-04-11 |
| 1780155648 | Eryn R Mcentee | Naturopath | 2216 Ne46th St, Seattle, WA 98105 | 2018-12-17 |
| 1356811921 | Kyle Leland Bernbach | Massage Therapist | 5224 Ravenna Ave Ne, Seattle, WA 98105 | 2018-11-27 |
| 1548742380 | Janal Kim | Physician Assistant | 4726 11th Ave Ne, Apt 511, Seattle, WA 98105 | 2018-08-29 |
| Find all providers in zip 98105 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750762415 | Anna Ohlsson | Surgery | 325 9th Ave # 359908, Seattle, WA 98104-2420 | 2015-06-17 |
| 1891986097 | Vascular Associates, Ps | Surgery | 801 Broadway Ste 522, Seattle, WA 98122-4325 | 2007-08-05 |
| 1447464730 | Mai Thanh Pham | Surgery | 1229 Madison St Suite # 1190, Seattle, WA 98104 | 2007-05-09 |
| 1366491045 | Kaj Johansen | Surgery | 600 Broadway Ste 112, Seattle, WA 98122-5381 | 2006-05-09 |
| 1568430908 | Swee Lian Tan | Surgery | 515 Minor Ave Ste 240, Seattle, WA 98104-2133 | 2006-03-10 |
| 1295730018 | Paul Gregory Hayes | Surgery | 801 Broadway Ste 500, Seattle, WA 98122-4396 | 2005-06-17 |
| 1184020307 | Usa Vein Clinics of Seattle, Pllc | Surgery | 10564 5th Ave Ne, Suite 102, Seattle, WA 98125-7200 | 2014-11-16 |
| 1942542212 | Matthew C Smith | Surgery | 1550 N 115th St, Seattle, WA 98133-8401 | 2013-03-25 |
| 1043579600 | Matthew Evans Bennett | Surgery | 1100 9th Ave, Seattle, WA 98101-2756 | 2012-05-16 |
| 1104185644 | Johnathon Curtis Rollo | Surgery | 1560 N 115th St, Seattle, WA 98133-8414 | 2012-05-03 |
| Find all providers in SEATTLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.