Provider Demographics
NPI:1801618442
Name:WALLES-MCCONAUGHEY, ELSIE
Entity type:Individual
Prefix:
First Name:ELSIE
Middle Name:
Last Name:WALLES-MCCONAUGHEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14027 NE 181ST ST APT B105
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-3556
Mailing Address - Country:US
Mailing Address - Phone:971-832-1379
Mailing Address - Fax:
Practice Address - Street 1:14027 NE 181ST ST APT B105
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-3556
Practice Address - Country:US
Practice Address - Phone:971-832-1379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula