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Individual

ELLIOT WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S.

Contact information

Practice address
1107 NE 45TH ST STE 315, SEATTLE, WA 98105-4656
(206) 785-1953
Mailing address
1414 DEXTER AVE N UNIT 116, SEATTLE, WA 98109-3470
(206) 402-8578

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
07/20/2023
Last updated
07/20/2023
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