Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellen Lyman Thomason Derrick, MD

Individual provider Vascular Surgery Physician · NPI 1659480630

Ellen Lyman Thomason Derrick, MD is a Vascular Surgery in Seattle, Washington. Qualified in 2001, 25 years ago. Licensed in Washington.

Years since qualifying
25
Licensed in
WA
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3216 NE 45th Pl Ste 207
Seattle, WA 98105-4028
Phone: (206) 596-3976
Fax: (206) 486-9013
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence MD00045873 (WA)

Record details

NPI number1659480630
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 30, 2006
Last updated in NPPESJuly 21, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyVASCULAR SURGERY
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Accepts Medicare assignment Not indicated

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