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Individual

ELI ELLIS OGBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
202 12TH AVE E, SEATTLE, WA 98102-5806
(919) 599-2813
Mailing address
202 12TH AVE E, SEATTLE, WA 98102-5806
(919) 599-2813

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
C008570
NC
1041C0700X
Clinical Social Worker
Primary
LW60681605
WA

Other

Enumeration date
02/21/2012
Last updated
01/10/2017
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