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Individual

SALLY MARIA EHLERS

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1720 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 736-1195
(360) 736-4952
Mailing address
1720 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 736-1195
(360) 736-4952

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00034793
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0115510
LABOR & INDUSTRIES
WA
01
20036773
RR MEDICARE
05
8209868
WA
01
EH0239
BLUE SHIELD
WA
Enumeration date
05/04/2006
Last updated
07/09/2007
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