Individual
KATELYN BROOKE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, WHNP, CNM
Contact information
Practice address
12220 SW 1ST ST STE 200, BEAVERTON, OR 97005-2890
(888) 875-7820
Mailing address
12220 SW 1ST ST STE 200, BEAVERTON, OR 97005-2890
(949) 636-9444
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
202207585NP-PP
OR
Other
Enumeration date
10/04/2018
Last updated
09/06/2022
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