Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OP60560271 | WA |
N | 207QA0401X | Family Doctor - Addiction Medicine | 13046 | CA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | OP60560271 | WA |
NPI | 1407286503 |
---|---|
Provider Name | Elizabeth Barrera |
First Address | Portland, OR 97208-3360 |
Second Address | Monroe, WA 98272 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2013 |
Last Update Date | 13/02/2019 |