Individual
AMY L ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1100 9TH AVE, SEATTLE, WA 98101-2756
(206) 583-2299
Mailing address
1100 9TH AVE, M4-PFS, SEATTLE, WA 98101-2756
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA-1022
ID
363AM0700X
Medical Physician Assistant
Primary
PA61202127
WA
Other
Enumeration date
11/08/2012
Last updated
05/12/2022
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