Provider Demographics
NPI:1912246539
Name:KRUMM, ELLEN (MA, LMHCA)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:KRUMM
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7215 153RD AVE NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4299
Mailing Address - Country:US
Mailing Address - Phone:425-883-0013
Mailing Address - Fax:
Practice Address - Street 1:7215 153RD AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4299
Practice Address - Country:US
Practice Address - Phone:425-883-0013
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-01
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60275944101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health