Dr. Ellis B. Jardine D.M.D.
Oral and Maxillofacial Surgery (Dentist) in Vancouver, WA(View on Map)
Full Name
Dr. Ellis Burke Jardine D.M.D.
NPI Number
1922205715
NPI Type
Individual Provider
Gender
Male
Enumeration Date
06/27/2007
Specialties
(Taxonomies)Code
1223S0112X
1223G0001X
1223P0700X
Primary Taxonomy
Yes
No
No
Licenses
State
Arizona
Tennessee
Texas
Washington
Washington
License Number
7240
9441
27917
DE60339865
DE 60339865
Contact
Information
Purpose
Mailing
Location
Address
3542 NE FRANKLIN ST
406C SE 131ST AVENUE
City
Camas
Vancouver
State
WA
WA
Postal Code
98607-6904
98683-4003
Country
US
US
Telephone Number
(480) 862-3185
(360) 253-9792
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/07/2023
Provider Address
Other Oral and Maxillofacial Surgery (Dentists) in Vancouver, Washington:
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Mariam Hamidi DMD
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Jonathan Chodroff DDS, MD
Vancouver, WASpecialties: Oral and Maxillofacial Surgery (Dentist) (Primary)Dentist