Provider Demographics
NPI:1407172885
Name:COATES, ELISABETH DENISE (RN)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:DENISE
Last Name:COATES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11991 SE 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-2078
Mailing Address - Country:US
Mailing Address - Phone:503-516-1402
Mailing Address - Fax:
Practice Address - Street 1:11991 SE 67TH AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-2078
Practice Address - Country:US
Practice Address - Phone:503-516-1402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-11
Last Update Date:2010-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200841381RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse