Provider Demographics
NPI:1194097121
Name:NOWAK, ELIZABETH RAMONA (RN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:RAMONA
Last Name:NOWAK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3601 SW RIVER PKWY
Mailing Address - Street 2:STE 1700
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4553
Mailing Address - Country:US
Mailing Address - Phone:503-894-9524
Mailing Address - Fax:
Practice Address - Street 1:3601 SW RIVER PKWY
Practice Address - Street 2:STE 1700
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4553
Practice Address - Country:US
Practice Address - Phone:503-894-9524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200942683RN163W00000X
AZRN049941163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse