Individual
MR. STEVEN EDWARD ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
57594 TYGH VALLEY RD, SUITE 2, TYGH VALLEY, OR 97063-8715
(541) 483-2362
Mailing address
PO BOX 297, TYGH VALLEY, OR 97063-0297
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27-1756
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
261750
—
OR
Enumeration date
11/07/2005
Last updated
08/24/2018
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