Individual
MARLENE J TRAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
305 N MAPLE ST, ELLENSBURG, WA 98926-3574
(509) 929-3636
Mailing address
305 N MAPLE ST, ELLENSBURG, WA 98926-3574
(509) 929-3636
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00023298
WA
Other
Enumeration date
09/11/2007
Last updated
09/11/2007
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