Karissa Ann Ellis, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

02004850A Issued in IN

Practice address

600 E Main St
Elma, WA 98541-9560

Phone

(360) 346-2222

NPI assigned

Apr 16, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: karissa.ellis@nhci.eclinicaldirectplus.com
• Direct secure messaging: kellis3076182@wm.providencedirect.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Grays Harbor County Public Hospital District No 1

  • Critical Access Hospital
  • Elma, WA
  • NPI 1740211028
  Medicare reassignment NPD
• Grays Harbor County Public Hospital District No 1

  • Rural Health Clinic/Center
  • Elma, WA
  • NPI 1083202907
  NPD
• Grays Harbor County Public Hospital District No. 1

  • Rural Health Clinic/Center
  • Elma, WA
  • NPI 1811025216
  NPD
• Grays Harbor County Public Hospital District No. 1

  • Rural Health Clinic/Center
  • Elma, WA
  • NPI 1942554183
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785888000000",
    "number": "1134486186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S CALHOUN ST",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468025257",
            "telephone_number": "260-458-2641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E MAIN ST",
            "city": "ELMA",
            "state": "WA",
            "postal_code": "985419560",
            "telephone_number": "360-346-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "KARISSA",
        "middle_name": "ANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "OP61458719",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "02004850A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Anthony Dietrich, M.D., MBA
• Kristin Rain Dineen, LMP
• Stephen L Drasnin, MD
• East Grays Harbor Fire and Rescue
• Edwards & Ketcher, PLLC
• Elma Health Care Clinic, LLC
• Elma School District
• Michael S. Fisher, CRNA
• Pauline J Foster
• Cristiana Maria Franklin, CDP

• Pediatrics Physician in Elma, WA
• Providers in Elma, WA by specialty
• Pediatrics Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.