Individual
AMANDA ELLIG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Taxonomy
Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
201606552RN
OR
Other
Enumeration date
09/20/2017
Last updated
07/21/2022
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