Provider Demographics
NPI:1558505032
Name:GRAFF, ELIZABETH (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GRAFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16463 BOONES FERRY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAKE OSWEGO
Mailing Address - State:OR
Mailing Address - Zip Code:97035-4259
Mailing Address - Country:US
Mailing Address - Phone:503-635-3743
Mailing Address - Fax:503-635-1508
Practice Address - Street 1:16463 BOONES FERRY RD
Practice Address - Street 2:SUITE 400
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-4259
Practice Address - Country:US
Practice Address - Phone:503-635-3743
Practice Address - Fax:503-635-1508
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-28
Last Update Date:2012-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD157640208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics