Provider Demographics
NPI:1467775288
Name:GREENHILL, ELIZABETH A (LAC, MACOM)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:GREENHILL
Suffix:
Gender:F
Credentials:LAC, MACOM
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:811 E BURNSIDE ST STE 216
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1231
Mailing Address - Country:US
Mailing Address - Phone:503-238-5203
Mailing Address - Fax:503-863-6342
Practice Address - Street 1:811 E BURNSIDE ST STE 216
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1231
Practice Address - Country:US
Practice Address - Phone:503-863-6342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-08
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC150427171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist