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Individual

DEBORAH LYNN ELLERMEIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
10702 19TH AVE SW, SEATTLE, WA 98146-2038
(206) 406-9884
Mailing address
10702 19TH AVE SW, SEATTLE, WA 98146-2038
(206) 406-9884

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
60852031
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
WDL3BSZ6933B
WA
Enumeration date
08/24/2021
Last updated
08/24/2021
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