MICHAEL WILLIAM ELLIS

PORTLAND, OR
NPI1235788936
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: PA  09797)
Enumeration Date2019-09-05
Last Update Date2019-09-05
Business Address
Mr. MICHAEL WILLIAM ELLIS PTA
12441 SE STARK ST
PORTLAND, OR 97233-1053
Phone number: 503-255-7040
Mailing Address
Mr. MICHAEL WILLIAM ELLIS PTA
3123 NE 29TH ST APT 306
GRESHAM, OR 97030-4372
Phone number: 971-320-9799
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