Ellenby, Miles Steven

Ellenby, Miles Steven is an individual health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Doernbecher Children'S Hospital Pediatric Icu, Portland OR 97239-3011. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Ellenby, Miles Steven can be contacted via phone (503) 418-5800.

Contact Information

Primary practice address
3181 Sw Sam Jackson Park Rd Doernbecher Children'S Hospital Pediatric Icu Portland OR 97239-3011
Phone: (503) 418-5800
Fax: (503) 418-5804
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X MD22157 Oregon

Profile Details

NPI number 1780692210
LBN Legal business name Ellenby, Miles Steven
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2006
Last updated Jul 14th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780692210 NPPES
Oregon MEDICAID 130353

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