Individual
ELLEN URSINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
202 N DIVISION ST, AUBURN, WA 98001-4939
(253) 833-7711
Mailing address
25506 122ND PL SE, KENT, WA 98030-5643
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003985
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8323826
—
WA
Enumeration date
05/03/2006
Last updated
04/14/2015
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