Individual
DR. ELLEN K. LIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
8301 161ST AVE NE, SUITE 300, REDMOND, WA 98052-3858
(206) 790-4908
Mailing address
8301 161ST AVE NE, SUITE 300, REDMOND, WA 98052-3858
(206) 790-4908
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY2815
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020782109
FEDERAL TAX ID
—
01
—
486617100000
PREMERA BLUE CROSS
WA
Enumeration date
05/16/2007
Last updated
04/20/2011
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