Provider Demographics
NPI:1760680524
Name:HULL, ELLEN B (CRC)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:B
Last Name:HULL
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 AUBURN WAY S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-6132
Mailing Address - Country:US
Mailing Address - Phone:425-228-3440
Mailing Address - Fax:253-395-1944
Practice Address - Street 1:1000 AUBURN WAY S
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-6132
Practice Address - Country:US
Practice Address - Phone:425-228-3440
Practice Address - Fax:253-395-1944
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0161291171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0161291OtherL&I PROVIDER
00016420OtherCRC