Individual
NATALIE JO ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
39 NE 102ND AVE, PORTLAND, OR 97220-4103
(503) 252-2461
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
62405
OR
Other
Enumeration date
09/05/2017
Last updated
09/05/2017
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