Provider Demographics
NPI:1972581163
Name:EHLERS, PATRICIA M
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:M
Last Name:EHLERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2603 NE 136TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98686-2756
Mailing Address - Country:US
Mailing Address - Phone:360-573-9854
Mailing Address - Fax:360-571-8272
Practice Address - Street 1:1010 WASHINGTON ST
Practice Address - Street 2:#280
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3167
Practice Address - Country:US
Practice Address - Phone:360-699-6374
Practice Address - Fax:360-571-8272
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00001183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7109556Medicaid