Provider Demographics
NPI:1780220095
Name:ELNISKI, ALEXA WINNIFRED MARY (DC)
Entity Type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:WINNIFRED MARY
Last Name:ELNISKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 VALLEY RIVER DR STE 260
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6760
Mailing Address - Country:US
Mailing Address - Phone:541-343-5633
Mailing Address - Fax:541-762-5633
Practice Address - Street 1:1400 VALLEY RIVER DR STE 260
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6760
Practice Address - Country:US
Practice Address - Phone:541-343-5633
Practice Address - Fax:541-762-5633
Is Sole Proprietor?:No
Enumeration Date:2019-11-21
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6044111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor