Individual
MARC R ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSWA
Contact information
Practice address
414 FRONT ST N, ISSAQUAH, WA 98027-2914
(425) 392-6367
(425) 391-4971
Mailing address
414 FRONT ST N, ISSAQUAH, WA 98027-2914
(425) 392-6367
(425) 391-4971
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SC60507250
WA
Other
Enumeration date
10/17/2018
Last updated
12/05/2018
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