NPI 1063911758

Eli Peckham, ATC

Practitioner Athletic Trainer Portland, OR

Practice location

Address: 930 SW Hall St, Portland, OR 97201
Phone: (206) 295-7320
Mailing address: 100 SE Olympia Dr APT 120, Vancouver, WA 98684-6941

Registered specialties (2)

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Oregon →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

Other Student in an Organized Health Care Education/Training Program providers in Oregon →

Registry record

NPI: 1063911758
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 Feb 2018
Record last updated: 15 Jun 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.