NPI 1154845204

Jude Regan Elliott, CPO

Practitioner Prosthetist Salem, OR

Practice location

Address: 675 12th St SE, Salem, OR 97301-4002
Phone: (503) 581-9191

Registered specialties

Prosthetist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 224P00000X Licence CPO1930 (OR)

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Registry record

NPI: 1154845204
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Jul 2017
Record last updated: 31 Jul 2017

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.