Ellis, Samantha Michelle

Ellis, Samantha Michelle is an sole proprietor health care provider with primary practice located at 11097 Se 21St Ave , Milwaukie OR 97222-7640. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is her primary health care specialty. Ellis, Samantha Michelle can be contacted via phone (971) 401-0364.

Contact Information

Primary practice address
11097 Se 21St Ave Milwaukie OR 97222-7640
Phone: (971) 401-0364
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X CG 60478731 Washington
Other Service Providers / Peer Specialist 175T00000X THW000002555 Oregon

Profile Details

NPI number 1841652567
LBN Legal business name Ellis, Samantha Michelle
Credentials Bachelor of Arts (BA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2016
Last updated Dec 7th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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