Individual
A CHANCELLOR PELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19200 N KELSEY ST, MONROE, WA 98272-1431
(360) 794-7994
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
(866) 366-2983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003136
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8324121
—
WA
Enumeration date
05/12/2006
Last updated
03/10/2015
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