Individual
ELIZABETH CHRISTIANE GENTZKOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4949 S MACADAM AVE, PORTLAND, OR 97239-3912
(971) 248-2651
Mailing address
4949 S MACADAM AVE, PORTLAND, OR 97239-3912
(971) 248-2651
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C4394
OR
101YP2500X
Professional Counselor
Primary
C4394
OR
Other
Enumeration date
01/10/2017
Last updated
01/02/2025
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