Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | DP201418 | OR |
NPI | 1033642335 |
---|---|
Provider Name | Lauren Eller |
First Address | Portland, OR 97223-6877 |
Second Address | Portland, OR 97223-6877 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2017 |
Last Update Date | 12/01/2021 |