Individual
ELLE KATHLEEN FISKUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
23175 224TH PL SE, MAPLE VALLEY, WA 98038-8230
(425) 399-3245
Mailing address
PO BOX 1461, MAPLE VALLEY, WA 98038-1461
(425) 615-1901
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/27/2023
Last updated
11/27/2023
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