Provider Demographics
NPI:1174666853
Name:GREIF, ELAINE (PHD)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:GREIF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10275 NW SKYLINE BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97231-2615
Mailing Address - Country:US
Mailing Address - Phone:503-283-9480
Mailing Address - Fax:503-219-9993
Practice Address - Street 1:501 N GRAHAM ST STE 365
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-2005
Practice Address - Country:US
Practice Address - Phone:503-281-3069
Practice Address - Fax:503-291-9993
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR448103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR104925Medicare ID - Type Unspecified
ORR94760Medicare UPIN