Individual
DAVID HOADLEY ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-3442
Mailing address
3502 SW JERALD CT, PORTLAND, OR 97221-4046
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD11737
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288171
—
OR
Enumeration date
10/09/2006
Last updated
07/08/2007
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