Individual
ELLENDEE PEPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
660 SW 39TH ST, STE 150, RENTON, WA 98057-4912
(425) 793-4700
(425) 656-4046
Mailing address
PO BOX 34876, SEATTLE, WA 98124-1876
(425) 228-3440
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD00022801
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0123182
L&I
WA
01
—
070011908
RR MEDICARE
WA
05
—
1008770
—
WA
01
—
PE0386
REGENCE
WA
Enumeration date
10/26/2006
Last updated
08/24/2017
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