Organization
ELLIOTT DENTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHELLE ELLIOTT DDS (OWNER)
(503) 661-6111
Entity
Organization
Contact information
Practice address
202 NE 181ST AVE STE A, PORTLAND, OR 97230-6664
(503) 661-6111
Mailing address
202 NE 181ST AVE STE A, PORTLAND, OR 97230-6664
(503) 661-6111
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285242354
—
OR
Enumeration date
07/27/2021
Last updated
07/27/2021
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