| Doctor Name: | STACEY A ELLINGSON |
| NPI Number: | 1104001452 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PT |
| License Number: | PT00010820 |
| Business Practice Address: | 19119 N Creek Pkwy Suite 107 Bothell, WA - 980118036 |
| Business Phone Number: | 4254868800 |
| Business Fax Number: | 4254858848 |
| Mailing Address: | Po Box 2170, SUMNER |
| State: | WA |
| Postal Code: | 983900480 |
| Phone Number: | 2538402313 |
| Fax Number: | 2538406340 |
| NPI Enumeration Date: | 01/07/2008 |
| NPI Last Update Date: | 12/27/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT00010820 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |