Gobble, John Ellis

Gobble, John Ellis is an individual health care provider with primary practice located at 6542 Se Lake Rd Ste 202C , Milwaukie OR 97222-2244. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Health Educator, Dietary & Nutritional Service Providers / Dietitian, Registered. Dietary & Nutritional Service Providers / Dietitian, Registered is his primary health care specialty. Gobble, John Ellis can be contacted via phone (503) 652-5070.

Contact Information

Primary practice address
6542 Se Lake Rd Ste 202C Milwaukie OR 97222-2244
Phone: (503) 652-5070
Fax: (800) 957-1067
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Health Educator 174H00000X
Dietary & Nutritional Service Providers / Dietitian, Registered 133V00000X 000543 Oregon

Profile Details

NPI number 1013919323
LBN Legal business name Gobble, John Ellis
Credentials DRPH, RD, LD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 1st, 2005
Last updated Nov 27th, 2024 - about 2 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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Identifiers

StateTypeNumberIssuer
All States NPI 1013919323 NPPES
Oregon MEDICAID 500641681

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