ELLEN MICHAELSON MD PC
Osteopathic Medicine at Northrup St, Portland, OR

License number
Oregon MD018281
Category
Osteopathic Medicine
Type
Hematology
Owner
Name: DR. ELLEN MARION MICHAELSON MD
Title: PRESIDENT
Phone: (503) 274-0045
Address
Address
2456 NW Northrup St UNIT 1-A, Portland, OR 97210
National Provider ID: 1245437110
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ELLEN MICHAELSON, M.D., PC

1040 NW 22 Ave #330, Portland, OR 97210

Registration:
Dec 29, 2006
State ID:
40349391
Business type:
DOMESTIC PROFESSIONAL CORPORATION
Agent:
S Wardgreene,1515 SW 5 Ave STE 600, Portland, OR 97201 (Physical)

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