Individual provider · Type 1 NPI

Ellen Sampson

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1134823404 Active

Practice location

1015 NW 22nd Ave
Portland, OR 97210-3025

Call (503) 413-8401 Map

Fax (503) 413-7361

Mailing address

1315 Everitt Memorial Hwy
Mount Shasta, CA 96067-9797

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1134823404

Ellen Sampson's National Provider Identifier is 1134823404, issued on Mar 29, 2023. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Mar 29, 2023.