Individual
ELLEN OUELLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
CEDAR HILLS ROAD & AZ 264, GANADO, AZ 86505
(928) 755-4500
(928) 755-4659
Mailing address
US 191 AND AZ 264, GANADO, AZ 87571-6282
(928) 755-4500
(928) 755-4659
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
79194
AZ
207Q00000X
Family Medicine Physician
Primary
MD2022-1085
NM
207Q00000X
Family Medicine Physician
MD61072960
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/07/2018
Last updated
02/05/2026
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