Provider Demographics
NPI:1114585361
Name:MURPHY, ELLEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:MURPHY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:MARKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT,DPT
Mailing Address - Street 1:27005 PACIFIC HWY S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-9250
Mailing Address - Country:US
Mailing Address - Phone:253-839-9280
Mailing Address - Fax:
Practice Address - Street 1:27005 PACIFIC HWY S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-9250
Practice Address - Country:US
Practice Address - Phone:253-839-9280
Practice Address - Fax:253-839-9375
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-03
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1318740225100000X
WAPT61271637225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist