Individual provider Active NPI

Ellen Worral, RDH

  • Dental Hygienist
  • Washougal, WA
National Provider Identifier
1902202179
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
DH 00005826 Issued in WA
Practice address
3307 Evergreen Way Ste 707
PMB 166
Washougal, WA 98671-2065
Phone
(360) 951-3772
NPI assigned
Nov 14, 2014
Last updated
Nov 14, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X DH 00005826 WA Primary

Addresses

Primary practice location

3307 Evergreen Way Ste 707
PMB 166
Washougal, WA 98671-2065

Mailing address

3307 Evergreen Way Ste 707
PMB 166
Washougal, WA 98671-2065
Phone (360) 951-3772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DH 00005826WAMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1415923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1902202179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3307 EVERGREEN WAY STE 707",
            "address_2": "PMB 166",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986712065",
            "telephone_number": "360-951-3772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3307 EVERGREEN WAY STE 707",
            "address_2": "PMB 166",
            "city": "WASHOUGAL",
            "state": "WA",
            "postal_code": "986712065",
            "telephone_number": "360-951-3772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORRAL",
        "first_name": "ELLEN",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-14",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "WA",
            "license": "DH 00005826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washougal, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.