Provider Demographics
NPI:1306502877
Name:ASH, ELIZABETH LYNN
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LYNN
Last Name:ASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 MEADOWS RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-0086
Mailing Address - Country:US
Mailing Address - Phone:503-345-3260
Mailing Address - Fax:503-345-3052
Practice Address - Street 1:14511 WESTLAKE DR STE 250
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-7774
Practice Address - Country:US
Practice Address - Phone:503-345-3260
Practice Address - Fax:503-345-3052
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist