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General NPI Number Information
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NPI Number | 1619915089
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Entity Type | Individual
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Provider Name | COURTNEY L ELTON MD
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 02/10/2010
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Provider Practice Location Address
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Address Line | 2005 W MAIN ST
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City | BATTLE GROUND
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State | WA
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Zip | 98604-4311
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Country | US
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Telephone | 360-397-1500
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Fax | 360-604-1762
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Provider Business Mailing Address
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Address Line | 700 NE 87TH AVE
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City | VANCOUVER
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State | WA
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Zip | 98664-1913
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Country | US
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Telephone | 360-397-1500
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Fax | 360-604-1771
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00041008
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License Number State | WA
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