Black, Elizabeth A
Black, Elizabeth A is an individual health care provider with primary practice located at 7927 Se Orient Dr , Gresham OR 97080. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Black, Elizabeth A can be contacted via phone (503) 663-0332.Contact Information
Primary practice address
7927 Se Orient Dr
Gresham OR 97080
Phone: (503) 663-0332
Fax: (503) 663-1114
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 4462 | Oregon |
Profile Details
| NPI number | 1932179025 |
|---|---|
| LBN Legal business name | Black, Elizabeth A |
| Credentials | BS PT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932179025 | NPPES |
| Oregon | MEDICAID | 181821 |
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