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Contact Information

SAMANTHA ELLIS
8915 SW CENTER ST
TIGARD, OR97223-6307
 Phone: 505-726-3740
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nutrition, Education

133NN1002X
Indicates primary specialty

NPI Profile & details for SAMANTHA ELLIS · (Female)

NPI Number 1710341391
Status Active
Credentials
Entity Individual
Enumeration date 04/08/2016
Last updated 04/08/2016 - About 10 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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