Individual
ELLEN DEZELLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
216 E 4TH ST, PORT ANGELES, WA 98362-3200
(360) 565-1733
Mailing address
443 CEDAR PARK DR, PORT ANGELES, WA 98362-8428
(509) 449-0644
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60535425
WA
Other
Enumeration date
02/20/2015
Last updated
02/20/2015
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