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1699062711
STACY LYNN ELLIS
VANCOUVER, WA
NPI
1699062711
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: WA PY60509345)
Enumeration Date
2011-07-10
Last Update Date
2015-08-17
Business Address
STACY LYNN ELLIS PSYD
2621 NE 134TH ST STE 340
VANCOUVER, WA 98686-3036
Phone number: 360-450-0140
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Mailing Address
STACY LYNN ELLIS PSYD
2204 SE 12TH AVE APT C
PORTLAND, OR 97214-5338
Phone number: 310-991-5923
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