Individual
ELLEN PORTRAIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
7150 SW DARTMOUTH ST, TIGARD, OR 97223-7614
(503) 968-3480
(503) 227-0676
Mailing address
7150 SW DARTMOUTH ST, TIGARD, OR 97223-7614
(503) 968-3480
(503) 227-0676
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
082011881RN
OR
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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