Individual
DR. JARED CALVIN ELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2531 BOONE RD SE, SALEM, OR 97306-9675
(503) 399-2424
(503) 585-2961
Mailing address
PO BOX 8100, SALEM, OR 97303-0900
(503) 399-2424
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
20A 8527
CA
207Q00000X
Family Medicine Physician
Primary
DO29385
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500610933
—
OR
01
—
P01752519
RAILROAD MEDICARE
OR
Enumeration date
10/24/2005
Last updated
02/23/2017
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