Individual
ELIZABETH NANCY ECKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, L475, PORTLAND, OR 97239-3011
(503) 494-8562
Mailing address
3181 SW SAM JACKSON PARK RD, L475, PORTLAND, OR 97239-3011
(503) 494-8562
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD17217
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD17217
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044219
—
OR
Enumeration date
09/20/2006
Last updated
07/11/2007
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