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Individual

ELLIOT MICHAEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
862 SE OAK ST STE 1A, HILLSBORO, OR 97123-4240
(503) 648-2200
(503) 693-1004
Mailing address
862 SE OAK STREET SUITE 1A, HILLSBORO, OR 97123-4240
(503) 648-2200
(503) 693-1004

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP00179
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0950720001
DMERC
OR
01
0977970001
DMERC
OR
05
162131
OR
Enumeration date
08/29/2006
Last updated
03/07/2023
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