MICHAEL R ELLEN MD PS NPI 1174637599

NPI Information

  • NPI: 1174637599
  • Provider Name: MICHAEL R ELLEN MD PS
  • Classification: Urology - 208800000X
  • Entity Type: Organization
  • Address: 128 LILLY RD NE
    SUITE 205
    OLYMPIA, WA
    ZIP 98506
  • Phone: (360) 754-3380

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NPI Details

MICHAEL R ELLEN MD PS is an urology in Olympia, WA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. MICHAEL R ELLEN MD PS NPI is 1174637599. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

128 LILLY RD NE
SUITE 205
OLYMPIA, WA
ZIP 98506-029
Phone: (360) 754-3380

The provider's authorized official is Michael R Ellen .
The authorized official title is Owner and has the following contact phone number (360) 754-3380.

The enumeration date for this NPI number is 8/19/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208800000XUrologyMD00026526WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11105360MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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