Provider Demographics
NPI:1518437193
Name:WILLIAMSON, ELLEN MARIE
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARIE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 JAQUELYN ST.
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1475
Mailing Address - Country:US
Mailing Address - Phone:541-631-9794
Mailing Address - Fax:
Practice Address - Street 1:825 JAQUELYN ST.
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1475
Practice Address - Country:US
Practice Address - Phone:541-631-9794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife