Ellis, Staci Gaye
Ellis, Staci Gaye is an individual health care provider with primary practice located at 7308 Bridgeport Way W Ste 103 , Lakewood WA 98499-8000. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Ellis, Staci Gaye can be contacted via phone (253) 582-8500.Contact Information
Primary practice address
7308 Bridgeport Way W Ste 103
Lakewood WA 98499-8000
Phone: (253) 582-8500
Fax: (253) 582-8160
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT7361 | Washington |
Profile Details
| NPI number | 1376543884 |
|---|---|
| LBN Legal business name | Ellis, Staci Gaye |
| Credentials | MSPT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 26th, 2005 |
| Last updated | Jun 3rd, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376543884 | NPPES |
| Washington | Other | 00007361 | PT LICENSE |
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