Individual
THOMAS LEE ELLINGSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1806 W LINCOLN AVE, YAKIMA, WA 98902-2473
(509) 452-4520
(509) 452-5224
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 494-6700
(509) 573-6275
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
16492
MS
207R00000X
Internal Medicine Physician
Primary
MD00029906
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00120845
—
MS
05
—
1427066083
—
WA
05
—
2041412
—
WA
Enumeration date
08/03/2006
Last updated
05/12/2020
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