Individual
ELISABETH SUMMER PROVOST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1890 11TH PL, SPRINGFIELD, OR 97477-2682
(541) 554-2624
Mailing address
1890 11TH PL, SPRINGFIELD, OR 97477-2682
(541) 554-2624
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
—
—
Other
Enumeration date
08/03/2026
Last updated
08/03/2026
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