Provider Demographics
NPI:1063941334
Name:ELLEFSON-PILLATOS, MIEKEL M
Entity type:Individual
Prefix:MS
First Name:MIEKEL
Middle Name:M
Last Name:ELLEFSON-PILLATOS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MIEKEL
Other - Middle Name:M
Other - Last Name:ELLEFSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICSW
Mailing Address - Street 1:2327 COURT G ST
Mailing Address - Street 2:APT #222
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405
Mailing Address - Country:US
Mailing Address - Phone:253-290-4502
Mailing Address - Fax:
Practice Address - Street 1:2327 COURT G ST
Practice Address - Street 2:APT #222
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-290-4502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW.616478281041C0700X
WASWI.LW.616478281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical