Individual
SAVANNAH N SELF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
820 W UMPTANUM RD, ELLENSBURG, WA 98926-8958
(509) 899-4650
Mailing address
820 W UMPTANUM RD, ELLENSBURG, WA 98926-8958
(509) 899-4650
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
CG60174371
WA
Other
Enumeration date
06/22/2010
Last updated
07/11/2013
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