Provider Demographics
NPI:1225057706
Name:ELTON, SUZANNE MARIE (MA LPC)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:MARIE
Last Name:ELTON
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14440 SW 153RD AVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-1876
Mailing Address - Country:US
Mailing Address - Phone:503-828-7878
Mailing Address - Fax:971-925-7001
Practice Address - Street 1:7100 SW HAMPTON ST
Practice Address - Street 2:STE 128
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8315
Practice Address - Country:US
Practice Address - Phone:503-828-7878
Practice Address - Fax:971-925-7001
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1980101Y00000X
WALH00011152101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor