Provider Demographics
NPI:1548969736
Name:DALY, ELLA (LMT)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:
Last Name:DALY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:E
Other - Last Name:PRIOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:PO BOX 934
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-0934
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:20736 BLACKSMITH CIR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-2242
Practice Address - Country:US
Practice Address - Phone:541-625-9707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-27
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20957225700000X
HI16907225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist