Individual
ELISHA M WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, CADCI
Contact information
Practice address
9670 SW BEAVERTON HILLSDALE HWY, PORTLAND, OR 97282
(503) 626-9494
(503) 626-9494
Mailing address
PO BOX 82819, PORTLAND, OR 97282-0819
(503) 626-9494
(503) 646-8401
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
060746
OR
Other
Enumeration date
04/17/2007
Last updated
03/18/2010
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