Individual
ELLIE ROSE COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2584 R W JOHNSON BLVD SW STE 100, TUMWATER, WA 98512-6103
(360) 878-6434
(844) 452-1758
Mailing address
3231 WILLAMETTE DR NE STE A, LACEY, WA 98516-1378
(360) 878-6434
(844) 452-1758
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB70056809
WA
Other
Enumeration date
10/22/2025
Last updated
10/22/2025
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