Provider Demographics
NPI:1023326253
Name:MCPHEE, ELIZABETH JANE (OT/L)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JANE
Last Name:MCPHEE
Suffix:
Gender:F
Credentials:OT/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1837 SW MARIGOLD ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-4147
Mailing Address - Country:US
Mailing Address - Phone:503-830-5680
Mailing Address - Fax:
Practice Address - Street 1:2500 NE 65 AVE
Practice Address - Street 2:ESD INFANT & TODDLER EARLY DEVELOPEMENT
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-6812
Practice Address - Country:US
Practice Address - Phone:360-750-7500
Practice Address - Fax:360-906-1010
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-22
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR282954225X00000X
WAOT 00001254225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist