Provider Demographics
NPI:1033284450
Name:GRIFFIN, ELIZABETH GRAVES (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:GRAVES
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:2685 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-6548
Mailing Address - Country:US
Mailing Address - Phone:503-581-1713
Mailing Address - Fax:503-581-3609
Practice Address - Street 1:2685 4TH ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301
Practice Address - Country:US
Practice Address - Phone:503-540-0288
Practice Address - Fax:503-540-0293
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2018-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR096006809N1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily