Individual
MS. GLENNA PERI EHLIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9600 VETERANS DR SW, TACOMA, WA 98493-0001
(253) 582-8440
Mailing address
5302 108TH STREET CT SW APT G5, LAKEWOOD, WA 98499-3555
(253) 588-0961
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002879
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011662
NCCPA CERTIFICATION
—
01
—
PA10002879
STATE OF WASHINGTON HPQAD
WA
Enumeration date
08/21/2006
Last updated
07/23/2009
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