Organization
PUGET SOUND NEUROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN M MODELL MD (NEUROLOGIST)
(425) 673-3800
Entity
Organization
Contact information
Practice address
7320 216TH ST SW, STE 310, EDMONDS, WA 98026-8006
(425) 673-3800
(425) 673-3802
Mailing address
7320 216TH ST SW, SUITE 310, EDMONDS, WA 98026-8006
(425) 673-3800
(425) 672-3803
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7087844
—
WA
01
—
CG9954
RR MEDICARE
WA
Enumeration date
08/30/2005
Last updated
12/23/2014
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