Healthcare Provider Details

I. General information

NPI: 1538819990
Provider Name (Legal Business Name): BYRON PATRICK ELLIOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 SHELTON MCMURPHEY BLVD STE 101
EUGENE OR
97401-5015
US

IV. Provider business mailing address

2788 RIVERWALK LOOP
EUGENE OR
97401-1536
US

V. Phone/Fax

Practice location:
  • Phone: 541-210-8090
  • Fax: 541-210-5310
Mailing address:
  • Phone: 504-615-4226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number10000811
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: