Individual
MS. ELIZABETH ANN PICOLOGLOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-2906
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD25734
OR
208M00000X
Hospitalist Physician
Primary
MD25734
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278107
—
OR
01
—
P01574764
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
12/11/2006
Last updated
03/24/2021
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