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Search › Oregon › 225200000X

Michael Ellis, PTA

NPI 1235788936 · on the registry since 2019 · sole proprietor

Practice

Address
12441 Se Stark St
Portland, OR 97233
Phone
(503) 255-7040
Organisation at this address
Portland Snf Operations, Llc
Evergreen Oregon Healthcare Portland, L.L.C.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
10

Registry record

Primary taxonomy
225200000X
225200000X
Licence states on file
PA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-09-05

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon