MEDICARE: EL ROI ENSY PSYCHIATRY PLLC

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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1245108729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EL ROI ENSY PSYCHIATRY PLLC

Provider Business Mailing Address
First Line	:	16301 NE 8TH ST STE 233
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-3962
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	16301 NE 8TH ST STE 233
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98008-3962
Country	:	US
Telephone Number	:	425-533-0212
Fax Number	:

Authorized Official
Title or Position	:	OWNER OF ENTITY
Name	:	NSEMBOOWO ENYONG
Credential	:
Telephone Number	:	425-533-0212

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	10/27/2025

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