# ELEMENTAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316241078
- **Authorized official:** DR. CARRIE N EBLING DC (PARTNER)
- **Authorized official phone:** (503) 505-9677

## Contact information

- **Practice address:** 2915 SE BELMONT ST, SUITE 1, PORTLAND, OR 97214
- **Practice address phone:** (503) 505-9677
- **Mailing address:** 2915 SE BELMONT ST, SUITE 1, PORTLAND, OR 97214
- **Mailing address phone:** (503) 505-9677

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | 3917 | OR | Yes |
| 261QM1300X | Multi-Specialty Clinic/Center | 8058 | OR | — |
| 261QM1300X | Multi-Specialty Clinic/Center | AC153123 | OR | — |

## Other

- **Enumeration date:** 01/10/2011
- **Last updated:** 01/10/2011