Healthcare Provider Details

I. General information

NPI: 1063399038
Provider Name (Legal Business Name): ELLA LORNG RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23961 NE STATE ROUTE 3
BELFAIR WA
98528-9698
US

IV. Provider business mailing address

355 VASHON CT NE
RENTON WA
98059-4649
US

V. Phone/Fax

Practice location:
  • Phone: 360-275-0953
  • Fax:
Mailing address:
  • Phone: 806-317-7552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61660564
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: