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NPI Code Detail

MEDICARE: ELLIE TEDFORD

MEDICARE: ELLIE TEDFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician106S00000XWA

General Provider Information

NPI Number : 1235068859
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLIE TEDFORD
Provider Business Mailing Address
First Line : 855 VIKING CIR
Second Line :
City : BELLINGHAM
State : WA
Zip : 98229-5537
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 231 SE BARRINGTON DR STE 203
Second Line :
City : OAK HARBOR
State : WA
Zip : 98277-3200
Country : US
Telephone Number : 360-509-2270
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ ELLIE TEDFORD ” Practice Location

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