Healthcare Provider Details

I. General information

NPI: 1245065432
Provider Name (Legal Business Name): ELLA TOKAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35843 13TH AVE SW
FEDERAL WAY WA
98023-7239
US

IV. Provider business mailing address

35843 13TH AVE SW
FEDERAL WAY WA
98023-7239
US

V. Phone/Fax

Practice location:
  • Phone: 253-332-1621
  • Fax:
Mailing address:
  • Phone: 253-332-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: