Provider Demographics
NPI:1770622904
Name:HARTSHORN, ELIZABETH R (LPC INTERN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:R
Last Name:HARTSHORN
Suffix:
Gender:F
Credentials:LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1882
Mailing Address - Street 2:
Mailing Address - City:WILSONVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97070
Mailing Address - Country:US
Mailing Address - Phone:503-588-2113
Mailing Address - Fax:503-635-9127
Practice Address - Street 1:15100 BOONES FERRY RD #800
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035
Practice Address - Country:US
Practice Address - Phone:503-588-2113
Practice Address - Fax:503-635-9127
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
ORC2101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health