Provider Demographics
NPI:1457586380
Name:STINSON, ELIZABETH J (MFT)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:J
Last Name:STINSON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 E BURNSIDE ST STE 206
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-1768
Mailing Address - Country:US
Mailing Address - Phone:503-327-1772
Mailing Address - Fax:
Practice Address - Street 1:423 NE 60TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-3725
Practice Address - Country:US
Practice Address - Phone:503-583-6400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA46452106H00000X
ORTO682106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist