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Organization
WARREN L ELLISON, M.D.
Active
Organization
WARREN L ELLISON, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF J BISHOP (ACCOUNT MANAGER)
(208) 683-2928
Entity
Organization
Contact information
Practice address
1207 EVERGREEN CT, CLARKSTON, WA 99403-2843
(208) 758-2928
(208) 758-2623
Mailing address
1207 EVERGREEN CT, CLARKSTON, WA 99403-2843
(208) 758-2928
(208) 758-2623
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00023004
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007293
—
WA
Enumeration date
07/17/2007
Last updated
04/11/2008
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