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Organization
ELLINGSON'S INC.
Active
Organization
ELLINGSON'S INC.
Active
Other names
Ellingson's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK VICTOR ELLINGSON (OWNER)
(503) 257-3373
Entity
Organization
Contact information
Practice address
6620 NE 79TH CT, SUITE 1, PORTLAND, OR 97218-2862
(503) 257-3373
(503) 408-9041
Mailing address
6620 NE 79TH CT, SUITE 1, PORTLAND, OR 97218-2862
(503) 257-3373
(503) 408-9041
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
RP-0000952-CS
OR
Other
Enumeration date
10/25/2006
Last updated
08/22/2020
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