Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Kenneth J Ellis, PHD

Individual provider Clinical Psychologist · NPI 1417973850

Dr. Kenneth J Ellis, PHD is a Clinical Psychologist in Marysville, Washington. Qualified in 1978, 48 years ago. Practices as a sole proprietor and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
48
Licensed in
WA
In the registry since
2006
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

1106 Columbia Ave Ste 100
Marysville, WA 98270-4335
Phone: (360) 653-0374
Fax: (360) 658-0219
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence PY00003392 (WA)

Record details

NPI number1417973850
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorYes
NPI enumeratedJuly 15, 2006
Last updated in NPPESFebruary 12, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 1978 (48 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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