Individual
MR. ELEE MARCEL FAIRHART
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
148 DIVISION STREET, MORTON, WA 98356
(360) 496-5335
(360) 496-5181
Mailing address
PO BOX 9, MORTON, WA 98356-0009
(360) 496-5335
(360) 496-5181
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00002616
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131920
L & I
WA
05
—
8334781
—
WA
Enumeration date
06/22/2005
Last updated
07/08/2007
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