Individual
JUSTIN KYLE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
925 SENECA ST, SEATTLE, WA 98101-2742
(206) 341-0468
(206) 625-7414
Mailing address
PO BOX 741515, LOS ANGELES, CA 90074-1515
(206) 341-0468
(206) 625-7414
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
83594
GA
2084P0800X
Psychiatry Physician
Primary
MD61624247
WA
Other
Enumeration date
04/02/2017
Last updated
09/26/2025
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