Individual
ELIZABETH EZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 SE 12TH AVE, PORTLAND, OR 97214-1323
(541) 231-5597
Mailing address
3439 NE SANDY BLVD, PORTLAND, OR 97232-1959
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
116807
OR
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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