Search › Washington › 1223S0112X
Ellis Jardine, D.M.D
NPI 1922205715 · on the registry since 2007 · sole proprietor
Practice
- Address
- 406c Se 131st Avenue
Suite 305
Vancouver, WA 98683 - Phone
- (360) 253-9792
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 1223S0112X
1223S0112X
- Also registered as
- 1223G0001X
1223P0700X
1223P0700X
1223P0700X - Licence states on file
- AZ, TX, WA, TN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-03-07
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 Washington