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General NPI Number Information
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NPI Number | 1598130049
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Entity Type | Individual
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Provider Name | SANDRA SUE ELLIS LMHCA
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Gender | Female
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Dates
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Enumeration Date | 12/09/2015
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 20102 CEDAR VALLEY RD STE 204
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City | LYNNWOOD
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State | WA
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Zip | 98036-6333
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Country | US
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Telephone | 425-367-3368
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Fax | 425-771-8400
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Provider Business Mailing Address
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Address Line | 20102 CEDAR VALLEY RD STE 106
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City | LYNNWOOD
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State | WA
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Zip | 98036-6333
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Country | US
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Telephone | 425-367-3368
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Fax | 425-771-8400
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH60718946
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License Number State | WA
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