Elleson Renee Tinkle
Nurse Practitioner in Portland, OR. Individual provider (NPI-1).
NPI number1124862610
StatusActive
Last updated in NPPESJun 20, 2024
Details
- NPI
- 1124862610
- Entity type
- Individual (NPI-1)
- Name
- Elleson Renee Tinkle
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 20, 2024
- Certification date
- Jun 20, 2024
- Last updated
- Jun 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 10023414 | OR | Yes |
Practice location
2311 Nw Northrup StPortland, OR 97210-2994
Phone 877-658-3594
Mailing address
2311 Nw Northrup StPortland, OR 97210-2994
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