Provider Demographics
NPI:1902415862
Name:SATCHELL, ELLIQUE LK
Entity Type:Individual
Prefix:
First Name:ELLIQUE
Middle Name:LK
Last Name:SATCHELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30834 7TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-4812
Mailing Address - Country:US
Mailing Address - Phone:206-851-3286
Mailing Address - Fax:
Practice Address - Street 1:113 23RD AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2309
Practice Address - Country:US
Practice Address - Phone:206-219-5980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-27
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor