Provider Demographics
NPI:1396965869
Name:CASSEN, ELLEN MARLOWE (ARNP, CNM)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARLOWE
Last Name:CASSEN
Suffix:
Gender:F
Credentials:ARNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HALL HEALTH CTR
Mailing Address - Street 2:BOX 354410
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-4410
Mailing Address - Country:US
Mailing Address - Phone:206-685-1048
Mailing Address - Fax:206-543-0457
Practice Address - Street 1:HALL HEALTH CTR
Practice Address - Street 2:BOX 354410
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-4410
Practice Address - Country:US
Practice Address - Phone:206-685-1048
Practice Address - Fax:206-543-0457
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30001031367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9603127Medicaid
WAP24896Medicare UPIN