Individual
NICOLE ELLYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
21603 84TH AVE W, EDMONDS, WA 98026-7818
(425) 431-7495
Mailing address
21603 84TH AVE W, EDMONDS, WA 98026-7818
(425) 431-7495
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN60470464
WA
Other
Enumeration date
11/03/2016
Last updated
11/03/2016
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