SAMANTHA ELLEFSON

PORTLAND, OR
NPI1902149750
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: OR  LD-D-10159207)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: GA  LD003133)
Enumeration Date2013-03-30
Last Update Date2013-12-12
Business Address
-- SAMANTHA ELLEFSON RD LD CSP
3181 S.W. SAM JACKSON PARK RD MAIL CODE: UHS 18
PORTLAND, OR 97239-3098
Phone number: 503-418-5257
Mailing Address
-- SAMANTHA ELLEFSON RD LD CSP
3181 SW SAM JACKSON PARK RD MAIL CODE: UHS 18
PORTLAND, OR 97239-3011
Phone number: 503-418-5257