Provider Demographics
NPI:1346038445
Name:COLLINS, ELLA MARIA
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:MARIA
Last Name:COLLINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:722 PANORAMA RDG
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-9134
Mailing Address - Country:US
Mailing Address - Phone:952-217-3656
Mailing Address - Fax:
Practice Address - Street 1:722 PANORAMA RDG
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-9134
Practice Address - Country:US
Practice Address - Phone:952-217-3656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-28
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program