Healthcare Provider Details

I. General information

NPI: 1154230589
Provider Name (Legal Business Name): ELIA NTIVIDAD ORTIZ CRUZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 N DAVIS CT
CORNELIUS OR
97113
US

IV. Provider business mailing address

2770 N DAVIS CT
CORNELIUS OR
97113
US

V. Phone/Fax

Practice location:
  • Phone: 503-906-0838
  • Fax:
Mailing address:
  • Phone: 503-906-0838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: