MARK OWEN ELLIS DPM NPI 1437240124

NPI Information

NPI: 1437240124
Provider Name: MARK OWEN ELLIS, DPM
Classification: Podiatrist - 213E00000X
Entity Type: Individual
Address:
582 22ND STREET
ASTORIA, OR
ZIP 97103
Phone: (503) 325-0045
Get Directions

Mark Owen Ellis, DPM is a podiatrist in Astoria, OR. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. Mark Owen Ellis, DPM NPI is 1437240124. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

582 22ND STREET
ASTORIA, OR
ZIP 97103
Phone: (503) 325-0045
Fax: (503) 325-3242

The enumeration date for this NPI number is 9/27/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213E00000X	Podiatrist		DP00095	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0000SGBCP	MEDICARE ID-TYPE UNSPECIFIED
2	056416	MEDICAID	OREGON
3	T88040	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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