Individual
WILLIAM BLAIR ELLIS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
611 W A ST, YAKIMA, WA 98902-2605
(509) 452-1000
(509) 452-1004
Mailing address
611 W A ST, YAKIMA, WA 98902-2605
(509) 452-1000
(509) 452-1004
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CP00002864
WA
101YP2500X
Professional Counselor
Primary
CL60157386
WA
Other
Enumeration date
12/03/2018
Last updated
12/03/2018
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