Provider Demographics
NPI:1043429657
Name:ESPINOZA, ELIZABETH TD (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TD
Last Name:ESPINOZA
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:T
Other - Last Name:DOUGLASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, MT-BC
Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-418-5800
Mailing Address - Fax:503-494-4951
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-418-5800
Practice Address - Fax:503-494-4951
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202113304NP-PP363LA2100X
IAC132033363L00000X, 363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner