Individual
ELI PECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
930 SW HALL ST, PORTLAND, OR 97201
(206) 295-7320
Mailing address
100 SE OLYMPIA DR APT 120, VANCOUVER, WA 98684-6941
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2018
Last updated
06/15/2023
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