Michael R Ellen MD Ps

NPI #1174637599 in Olympia, Washington

Provider Information

NPI Number: 1174637599
Entity Type: Organization
Organization Name: Michael R Ellen MD Ps
Primary Specialty: Urology
Enumeration Date: Aug 19, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 128 LILLY RD NE
Address 2: SUITE 205
City: Olympia
State: Washington
ZIP Code: 98506-5029
Phone: (360) 754-3380

Authorized Official

Name: MICHAEL R ELLEN, MD
Title: OWNER
Phone: (360) 754-3380

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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