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

Mr. Fred E Ellis, DPDDENTURISTOFPRO

Individual provider Denturist · NPI 1891835310

Mr. Fred E Ellis, DPDDENTURISTOFPRO is a Denturist in Olympia, Washington. Licensed in Washington. Registered with an NPI since 2007.

Licensed in
WA
In the registry since
2007
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Practice location Address checks out

1822 Black Lake Blvd SW Ste 101
Olympia, WA 98512
Phone: (360) 709-9909
Fax: (360) 709-9915
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Denturist (primary) Taxonomy 122400000X · Licence DN00000358 (WA)

Record details

NPI number1891835310
Entity typeIndividual (Type 1)
GenderMale
Credentials DPDDENTURISTOFPRO
Sole proprietorNo
NPI enumeratedFebruary 7, 2007
Last updated in NPPESJuly 8, 2007
Mailing address1822 Black Lake Blvd Sw, Suite 101, Olympia, WA 98512

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