Individual
CARA DAVIDSON ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
315 SE STONE MILL DR, SUITE 102, VANCOUVER, WA 98684-6998
(360) 816-2700
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60296002
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500649465
—
OR
01
—
P01178829
RAILROAD MEDICARE - PHS
WA
Enumeration date
05/14/2009
Last updated
07/02/2021
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