Individual
ELIZABETH ELLEN WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC, RLC, CPPD
Contact information
Practice address
3323 SW NAITO PKWY, PORTLAND, OR 97239-4672
(503) 755-8328
(503) 506-0676
Mailing address
462 SW VALERIA VIEW DR APT 303, PORTLAND, OR 97225-7085
(503) 755-8328
(503) 506-0676
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
LC-10196698
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500820297
—
OR
01
—
L-152153
INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS
VA
01
—
LC-LC-10196698
OREGON HEALTH LICENSING-LACTATION CONSULTANT PROGRAM
OR
Enumeration date
01/29/2019
Last updated
06/06/2024
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