Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT00004059 | WA |
NPI | 1083727879 |
---|---|
Provider Name | Mrs. Ellen Mary Ferris |
First Address | Shoreline, WA 98155-2134 |
Second Address | Seattle, WA 98108-1532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 08/07/2007 |