Individual
ELIZABETH FARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12505 SE RAYMOND STREER, PORTLAND, OR 97236
(503) 760-8300
(503) 760-8308
Mailing address
3587 HEATHROW WAY, MEDFORD, OR 97504-4004
(541) 858-8170
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
PROFESSIONALLICENSE
—
Other
Enumeration date
05/13/2020
Last updated
10/19/2022
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