Provider Demographics
NPI:1962688788
Name:SUNDSTROM, ELLEN MARIE (RN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:MARIE
Last Name:SUNDSTROM
Suffix:
Gender:F
Credentials:RN, FNP-BC
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Mailing Address - Street 1:10011 BRIDGEPORT WAY SE SUITE 1500 PMB 201
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2332
Mailing Address - Country:US
Mailing Address - Phone:214-686-3588
Mailing Address - Fax:
Practice Address - Street 1:ELEANOR HEALTH SEATTLE CLINIC
Practice Address - Street 2:1120 E TERRACE STREET SUITE 100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-7405
Practice Address - Country:US
Practice Address - Phone:206-594-1065
Practice Address - Fax:833-654-0691
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP116342363LF0000X
AZ219835363LF0000X
OR201907446NP-PP363LF0000X
AK133766363LF0000X
WAAP60650034363LF0000X
COAPN.0991820-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily