Organization
ELLEN POLSKY DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE LOREE (PRACTICE MANAGEMENT)
(503) 551-0865
Entity
Organization
Contact information
Practice address
9317 113TH ST E STE A, PUYALLUP, WA 98373-3876
(253) 848-7000
Mailing address
9317 113TH ST E STE A, PUYALLUP, WA 98373-3876
(253) 848-7000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10757
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1055311
—
WA
Enumeration date
11/08/2010
Last updated
11/08/2010
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