| Doctor Name: | ELLA YEPRAKSIA BOSTANJIAN |
| NPI Number: | 1871735647 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | MD60039274 |
| Business Practice Address: | 617 5th Ave S Edmonds, WA - 980203452 |
| Business Phone Number: | 4256972100 |
| Business Fax Number: | 4256975556 |
| Mailing Address: | 617 5th Ave S, EDMONDS |
| State: | WA |
| Postal Code: | 980203452 |
| Phone Number: | 4256972100 |
| Fax Number: | 4256975556 |
| NPI Enumeration Date: | 03/25/2009 |
| NPI Last Update Date: | 09/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | MD60039274 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |