Individual
DR. ELISE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5050 NE HOYT ST, SUITE 315, PORTLAND, OR 97213-2991
(503) 215-8580
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
A104039
CA
2084N0400X
Neurology Physician
Primary
MD150867
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500623508
—
OR
Enumeration date
06/24/2008
Last updated
01/19/2021
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