Individual
ALEX LOGAN ELWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA-R
Contact information
Practice address
4941 NE 17TH AVE, PORTLAND, OR 97211-5709
(503) 282-3296
Mailing address
14912 SW TICKLE CREEK RD, BORING, OR 97009
(856) 535-7583
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/16/2021
Last updated
09/16/2021
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