Provider Demographics
NPI:1275252611
Name:HELMS, ELISE (MS)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:HELMS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:ELISE
Other - Middle Name:
Other - Last Name:KUYKENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:724 NE 68TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97213-5526
Mailing Address - Country:US
Mailing Address - Phone:503-367-1156
Mailing Address - Fax:
Practice Address - Street 1:1306 NW HOYT ST STE 306
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-2786
Practice Address - Country:US
Practice Address - Phone:971-407-3930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR7812101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional