Fred E Ellis is a Denturist in Olympia, Washington. Fred E Ellis practices all healthcare services and medical treatments related to Denturist. The NPI Number for Fred E Ellis is 1891835310. The last update date is 2007-07-08.
Fred E Ellis's current location address is 1822 Black Lake Blvd Sw, Olympia, Washington. You can contact this provider via phone number 3607099909 and fax number 3607099915. The mailing address for Fred E Ellis is 1822 Black Lake Blvd Sw, Olympia, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Fred E Ellis |
|---|---|
| Address | 1822 Black Lake Blvd Sw, Olympia, Washington |
| Phone Number | 3607099909 |
| Fax Number | 3607099915 |
| Sole Proprietor | N |
| Credentials | DPD DENTUR |
NPI Number Detail
| NPI Number | 1891835310 |
|---|---|
| Provider Enumeration Date | 2007-02-07 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1822 Black Lake Blvd Sw |
|---|---|
| City | Olympia |
| State | Washington (WA) |
| Post Code | 98512 |
| Phone Number | 3607099909 |
| Fax Number | 3607099915 |
Provider's Primary Taxonomy Detail
| Speciality | Denturist |
|---|---|
| Taxonomy | 122400000X |
| Licence No | DN00000358 |
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Definition: A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 5046370 | WA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Fred E Ellis by the Centers for Medicare & Medicaid Services?
The Fred E Ellis has been assigned the NPI (National Provider Identifier) 1891835310. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Fred E Ellis's physical address?
The Fred E Ellis is physically located at 1822 Black Lake Blvd Sw, in the city of Olympia, WA, with the postal code 98512.
What is the Fred E Ellis's area of specialization and corresponding taxonomy classification?
The Fred E Ellis's specialty field is Denturist, and it falls under the taxonomy code 122400000X, which categorizes healthcare providers based on their specialties.
On what date did the Centers for Medicare & Medicaid Services issue the 1891835310 to Fred E Ellis?
The Fred E Ellis received its 1891835310 assignment from the Centers for Medicare & Medicaid Services on 2007-02-07.
As of what date were the details pertaining to Fred E Ellis last refreshed?
The information related to the Fred E Ellis, including its address, specialty, and other relevant details, was last updated on 2007-07-08.
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