Provider Demographics
NPI:1790166957
Name:WILLIAMS, ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24614 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:OR
Mailing Address - Zip Code:97456-9437
Mailing Address - Country:US
Mailing Address - Phone:541-914-0845
Mailing Address - Fax:
Practice Address - Street 1:24614 WILLIAMS RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:OR
Practice Address - Zip Code:97456-9437
Practice Address - Country:US
Practice Address - Phone:541-914-0845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-13
Last Update Date:2015-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9038183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist