Provider Demographics
NPI:1841411287
Name:GOTTHEIL, ELLEN FRANCES (MD)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:FRANCES
Last Name:GOTTHEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8441 SE 68TH ST # 259
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-5235
Mailing Address - Country:US
Mailing Address - Phone:206-860-2447
Mailing Address - Fax:
Practice Address - Street 1:2811 E MADISON ST STE 205C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4885
Practice Address - Country:US
Practice Address - Phone:206-860-2447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000269712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry