Ellis, Samantha

Ellis, Samantha is an sole proprietor health care provider with primary practice located at 8915 Sw Center St , Tigard OR 97223-6307. She recently has only one registered license in Dietary & Nutritional Service Providers / Nutrition, Education, which is considered as her primary health care specialty. Ellis, Samantha can be contacted via phone (505) 726-3740.

Contact Information

Primary practice address
8915 Sw Center St Tigard OR 97223-6307
Phone: (505) 726-3740
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dietary & Nutritional Service Providers / Nutrition, Education 133NN1002X

Profile Details

NPI number 1710341391
LBN Legal business name Ellis, Samantha
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 8th, 2016
Last updated Apr 8th, 2016 - about 9 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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