Individual
MR. JACOB M ELLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3704 N 35TH ST, TACOMA, WA 98407-6033
(253) 312-8909
Mailing address
5405 SW EDMUNDS ST, SEATTLE, WA 98116-4358
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
BA60906822
WA
103K00000X
Behavior Analyst
—
—
106S00000X
Behavior Technician
CB60781741
WA
Other
Enumeration date
02/19/2018
Last updated
12/10/2020
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