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General NPI Number Information
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NPI Number | 1679827513
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Entity Type | Organization
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Legal Business Name | CAROLEIGH ELLIOTT, DC
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Dates
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Enumeration Date | 10/30/2012
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 7524 SE MILWAUKIE AVE
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City | PORTLAND
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State | OR
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Zip | 97202-6113
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Country | US
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Telephone | 971-212-0045
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Fax | 503-238-1110
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Provider Business Mailing Address
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Address Line | 7524 SE MILWAUKIE AVE
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City | PORTLAND
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State | OR
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Zip | 97202-6113
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Country | US
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Telephone | 971-212-0045
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Fax | 503-238-1110
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAROLEIGH JEAN ELLIOTT
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Credential | BSC, DC
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Telephone | 971-212-0045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 3171
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License Number State | OR
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