Provider Demographics
NPI:1437126067
Name:HANNON, ELENA M (MD)
Entity type:Individual
Prefix:
First Name:ELENA
Middle Name:M
Last Name:HANNON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MADISON ST STE 1150
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3558
Mailing Address - Country:US
Mailing Address - Phone:206-386-3400
Mailing Address - Fax:206-386-3411
Practice Address - Street 1:1101 MADISON ST STE 1150
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-386-3400
Practice Address - Fax:206-386-3411
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD14215207V00000X
CAC192825207V00000X
WAMD00037276207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD1437126067Medicaid
CA100509006Medicaid
WA1010288Medicaid