Individual
SEAN PATRICK ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCMHC
Contact information
Practice address
8285 SW NIMBUS AVE STE 130, BEAVERTON, OR 97008-6428
(503) 610-2044
Mailing address
8285 SW NIMBUS AVE STE 130, BEAVERTON, OR 97008-6428
(503) 610-2044
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
1999
NH
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C5453
OR
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
07/06/2009
Last updated
04/15/2022
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