Provider Demographics
NPI:1144031436
Name:CHUBB, ELIZABETH CAPEN WETZEL
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CAPEN WETZEL
Last Name:CHUBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10652 SAND POINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6924
Mailing Address - Country:US
Mailing Address - Phone:206-512-0862
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 25262
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98165-2162
Practice Address - Country:US
Practice Address - Phone:206-512-0862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-15
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant