Provider Demographics
NPI:1598072019
Name:ELLE, DON (LMFT CDP)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:
Last Name:ELLE
Suffix:
Gender:M
Credentials:LMFT CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 132ND AVE NE
Mailing Address - Street 2:#107
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8628
Mailing Address - Country:US
Mailing Address - Phone:425-221-8275
Mailing Address - Fax:
Practice Address - Street 1:2310 130TH AVE NE
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1799
Practice Address - Country:US
Practice Address - Phone:425-221-8275
Practice Address - Fax:425-867-5045
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60098310106H00000X
WACPO60143886101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)