Individual
MR. ELIJAH TELFARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
500 LILLY RD NE, SUITE 100, OLYMPIA, WA 98506-5195
(360) 491-4211
(360) 493-0407
Mailing address
PO BOX 368, OLYMPIA, WA 98507-0368
(360) 491-8439
(360) 491-6328
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10002241
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7066269
—
WA
Enumeration date
03/21/2007
Last updated
10/05/2007
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