Individual
MRS. ELIZABETH MARIE PANCOAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
4029 NE TILLAMOOK ST, PORTLAND, OR 97212-5341
(415) 583-3185
Mailing address
4029 NE TILLAMOOK ST, PORTLAND, OR 97212-5341
(415) 583-3185
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
016476
OR
235Z00000X
Speech-Language Pathologist
SLPL4842
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
982597
ACCESS
AZ
Enumeration date
03/14/2007
Last updated
07/11/2022
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