Individual
MRS. ELLEN BARBARA CASSILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
18526 DRIFTWOOD DR E, LAKE TAPPS, WA 98391-9466
(253) 862-7819
Mailing address
18526 DRIFTWOOD DR E, LAKE TAPPS, WA 98391
(253) 862-7819
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH00002017
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902058
—
WA
Enumeration date
08/14/2007
Last updated
08/14/2007
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