Provider Demographics
NPI:1194867044
Name:RICE, ELIZABETH A (LMT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:A
Last Name:RICE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:MIDDLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:1041 BEACH DR APT 3
Mailing Address - Street 2:
Mailing Address - City:SEASIDE
Mailing Address - State:OR
Mailing Address - Zip Code:97138-5433
Mailing Address - Country:US
Mailing Address - Phone:503-516-2135
Mailing Address - Fax:
Practice Address - Street 1:1041 BEACH DR APT 3
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:OR
Practice Address - Zip Code:97138-5433
Practice Address - Country:US
Practice Address - Phone:503-516-2135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6912174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist