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MR. FRED E ELLIS DPD DENTURIST OF PRO
NPI 1891835310
Denturist in Olympia, WA

Active since February 07, 2007
1822 BLACK LAKE BLVD SW, SUITE 101, OLYMPIA, WA 98512(360) 709-9909(360) 709-9915 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Fred E Ellis Dpd Denturist Of Pro NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. FRED E ELLIS DPD DENTURIST OF PRO (NPI 1891835310) is an individual denturist in Olympia, Washington, licensed in Washington (DN00000358) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1891835310
Entity TypeIndividualMale
Primary Taxonomy122400000X
Provider Legal NameMR. FRED E ELLISCredential: DPD DENTURIST OF PRO
Location Address1822 BLACK LAKE BLVD SW, SUITE 101Olympia, WA 98512
Mailing Address1822 Black Lake Blvd Sw, Suite 101Olympia, WA 98512 · (360) 709-9909 · Fax (360) 709-9915
Phone(360) 709-9909
Fax(360) 709-9915
Sole ProprietorNo
Enumeration DateFebruary 7, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1891835310 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDenturistDental Providers
Taxonomy Code122400000X
License✔ Licensed in WA · DN00000358
Definition
A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in removable dental prosthetics and the fabrication of such devices.
1822 BLACK LAKE BLVD SW, Olympia, WA 98512
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Other Identifiers 1

Medicaid5046370WA

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDWARD I DAGHER MD PLLC
Clinic/Center (Medical Specialty)
1822 BLACK LAKE BLVD SW, SUITE 102
OLYMPIA, WA 98512
Thurston County (360) 358-3255
DR. EDWARD I. DAGHER MD
Physical Medicine & Rehabilitation
1822 BLACK LAKE BLVD SW, SUITE 102
OLYMPIA, WA 98512
Thurston County (360) 877-8862
MS. DIXIE RHODES HAVLAK R.D.
Dietitian, Registered
1822 BLACK LAKE BLVD SW, SUITE 102-C
OLYMPIA, WA 98512
Thurston County (360) 357-1410
BRENDA MARIE CORKUM MA LMHC
Counselor (Mental Health)
1822 BLACK LAKE BLVD SW, SUITE 102-D
OLYMPIA, WA 98512
Thurston County (360) 866-2919

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fred Ellis's NPI number?

The NPI number for Fred Ellis is 1891835310. It was assigned to this individual provider in the NPPES registry on February 7, 2007.

Where is Fred Ellis located?

Fred Ellis practices at 1822 Black Lake Blvd SW Suite 101, Olympia, WA 98512. The listed phone number is (360) 709-9909.

What is Fred Ellis's specialty?

The primary specialty registered for this NPI is Denturist with taxonomy code 122400000X.

When was this NPI record last updated?

The NPPES record for Fred Ellis was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.