Provider Demographics
NPI:1609977750
Name:ETHINGTON, ELLEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:
Last Name:ETHINGTON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9507 N DIVISION ST
Mailing Address - Street 2:STE F
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1553
Mailing Address - Country:US
Mailing Address - Phone:509-456-3600
Mailing Address - Fax:509-747-4420
Practice Address - Street 1:9507 N DIVISION ST
Practice Address - Street 2:STE F
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1553
Practice Address - Country:US
Practice Address - Phone:509-456-3600
Practice Address - Fax:509-747-4420
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3263103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical