Provider Demographics
NPI:1891864096
Name:STEVENS, ELIZABETH MAUREEN I
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MAUREEN
Last Name:STEVENS
Suffix:I
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 CONNECTICUT AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-2300
Mailing Address - Country:US
Mailing Address - Phone:541-756-9234
Mailing Address - Fax:
Practice Address - Street 1:2000 CONNECTICUT AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-2300
Practice Address - Country:US
Practice Address - Phone:541-756-9234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other