MEDICARE: ELLINGTON ADHD CLINIC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1891647426
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLINGTON ADHD CLINIC LLC

Provider Business Mailing Address
First Line	:	17683 SW COBB LN
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-9501
Country	:	US
Telephone Number	:	971-299-7255
Fax Number	:	971-231-0217

Provider Business Practice Location Address
First Line	:	17683 SW COBB LN
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97007-9501
Country	:	US
Telephone Number	:	971-299-7255
Fax Number	:	971-231-0217

Authorized Official
Title or Position	:	PMHNP
Name	:	JESSICA N ELLINGTON
Credential	:	PMHNP-BC
Telephone Number	:	971-299-7255

Provider Enumeration Date	:	02/14/2026
Last Update Date	:	02/14/2026

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