Individual
MICHELLE LEE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
5821 N HERMOSA CIR, OTIS ORCHARDS, WA 99027-8278
(509) 209-6836
Mailing address
5821 N HERMOSA CIR, OTIS ORCHARDS, WA 99027-8278
(509) 209-6836
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC00001159
WA
224Z00000X
Occupational Therapy Assistant
OTA-228
ID
Other
Enumeration date
12/13/2012
Last updated
12/13/2012
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