Individual
CORWYN ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3214 W MCGRAW ST, STE 212, SEATTLE, WA 98199-3239
(206) 453-4882
Mailing address
10224 NE TORVANGER RD, BAINBRIDGE ISLAND, WA 98110-4178
(206) 617-2299
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CG60614988
WA
Other
Enumeration date
11/06/2015
Last updated
10/26/2016
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