Individual
ELLEN B MORTENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
16376 28TH PL NE, SHORELINE, SHORELINE, WA 98155-6417
(206) 459-3556
Mailing address
16376 28TH PL NE, SHORELINE, WA 98155-6417
(206) 459-3556
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LW00004069
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8356966
—
WA
Enumeration date
01/19/2007
Last updated
04/29/2020
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