Provider Demographics
NPI:1568175909
Name:RHOADES, ELIZABETH DAWN (LMT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DAWN
Last Name:RHOADES
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:DAWN
Other - Last Name:RHOADES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT
Mailing Address - Street 1:12490 LOCUST FARM CT
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-2559
Mailing Address - Country:US
Mailing Address - Phone:971-221-7768
Mailing Address - Fax:
Practice Address - Street 1:1300 JOHN ADAMS ST # 102
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1695
Practice Address - Country:US
Practice Address - Phone:971-221-7768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-30
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27493225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist