Individual
TESSA ELLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1472 19TH AVE, FOREST GROVE, OR 97116-3502
(503) 804-0105
Mailing address
1472 19TH AVE, FOREST GROVE, OR 97116-3502
(503) 804-0105
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
201504378RN
OR
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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