Individual
AMELIA ELISABETH CANRIGHT ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
441 NW ELKS DR STE 101, CORVALLIS, OR 97330-3744
(541) 768-5200
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085003759
IL
363A00000X
Physician Assistant
Primary
PA222049
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0110004231
LICENSE
VA
01
—
085003759
LICENSE
IL
Enumeration date
06/23/2010
Last updated
10/28/2024
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