Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 1981 | OR |
NPI | 1003060088 |
---|---|
Provider Name | Ms. Elizabeth Sutherland Race |
First Address | Lake Oswego, OR 97034-3938 |
Second Address | Lake Oswego, OR 97034-3938 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2008 |
Last Update Date | 04/11/2008 |