Jessica Laine Ellis
Family Doctor - Sports Medicine
1435 G St
Springfield
, Oregon 97477-4113
Jessica Laine Ellis
Family Doctor - Sports Medicine
1435 G St
Springfield
, Oregon 97477-4113
(541) 284-2038
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About
Features
Specialties
- Family Doctor - Sports Medicine
Languages spoken
- English
Location
First Address
- Jessica Laine Ellis
- Po Box 1648
- Eugene, OR
- Zip : 97440-1648
- Fax : (541) 284-2038
- Phone : (541) 242-4812
Second Address
- Jessica Laine Ellis
- 1435 G St
- Springfield, OR
- Zip : 97477-4113
- Fax : (541) 242-4813
- Phone : (541) 242-4812
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207QS0010X | Family Doctor - Sports Medicine | MD172850 | OR |
National Provider Identifier
| NPI | 1245270222 |
|---|---|
| Provider Name | Jessica Laine Ellis |
| First Address | Eugene, OR 97440-1648 |
| Second Address | Springfield, OR 97477-4113 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/06/2006 |
| Last Update Date | 04/12/2015 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 500694329 | (05) | OR |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.