Provider Demographics
NPI:1033547484
Name:PHINNEY, ELIZABETH ANNE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:PHINNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:
Other - Last Name:PHINNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:800 FRANKLIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3356
Mailing Address - Country:US
Mailing Address - Phone:509-599-5128
Mailing Address - Fax:360-326-1956
Practice Address - Street 1:750 OFFICERS ROW
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-3845
Practice Address - Country:US
Practice Address - Phone:509-599-5128
Practice Address - Fax:360-326-1956
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2024-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007857101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health