Provider Demographics
NPI:1184980393
Name:WITTORFF, ELISABETH J (LCSW)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:J
Last Name:WITTORFF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:J
Other - Last Name:WITTORFF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:8383 NE SANDY BLVD STE 320E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-4968
Mailing Address - Country:US
Mailing Address - Phone:971-232-1267
Mailing Address - Fax:
Practice Address - Street 1:8383 NE SANDY BLVD STE 320E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4968
Practice Address - Country:US
Practice Address - Phone:971-232-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-02
Last Update Date:2019-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL51421041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical