Individual
ANDREW P ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1815 SW MARLOW, SUITE 110, PORTLAND, OR 97225-5185
(503) 292-0765
(503) 292-5208
Mailing address
7204 SW DURHAM RD, STE 100, PORTLAND, OR 97224-7574
(503) 941-9869
(503) 352-5555
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1396
OR
Other
Enumeration date
09/11/2006
Last updated
12/15/2021
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