Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101Y00000X | Counselor | C4569 | OR |
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 150901 | OR |
NPI | 1003355454 |
---|---|
Provider Name | Elissa Barbee |
First Address | Portland, OR 97214-2347 |
Second Address | Portland, OR 97214-2347 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/02/2017 |
Last Update Date | 17/03/2018 |