| Warren L Ellison, M.d. | |
|
1207 Evergreen Ct Clarkston WA 99403-2843 | |
| (208) 758-2928 | |
| (208) 758-2623 |
| Full Name | Warren L Ellison, M.d. |
|---|---|
| Speciality | Family Medicine |
| Location | 1207 Evergreen Ct, Clarkston, Washington |
| Authorized Official Name and Position | Jeff J Bishop (ACCOUNT MANAGER) |
| Authorized Official Contact | 2086832928 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Warren L Ellison, M.d. 1207 Evergreen Ct Clarkston WA 99403-2843 Ph: (208) 758-2928 | Warren L Ellison, M.d. 1207 Evergreen Ct Clarkston WA 99403-2843 Ph: (208) 758-2928 |
| NPI Number | 1619176799 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 04/11/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619176799 | NPI | - | NPPES |
| 1007293 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD00023004 (Washington) | Primary |
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