Individual
JESSICA IRENE ELLIGOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDCES, MS, RDN, CDN
Contact information
Practice address
2101 NE 139TH ST STE 460, VANCOUVER, WA 98686-2325
(360) 360-4872
Mailing address
19000 SE 23RD ST, VANCOUVER, WA 98683-9794
(360) 601-2580
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
DI60596850
WA
163WD0400X
Diabetes Educator Registered Nurse
DI60596850
OR
163WD0400X
Diabetes Educator Registered Nurse
Primary
DI60596850
WA
Other
Enumeration date
11/21/2019
Last updated
11/07/2023
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