Provider Demographics
NPI:1053936260
Name:SCOTT, ELIZABETH JOANNE (LAC)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JOANNE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:S
Other - Last Name:PITTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5035 NE ELAM YOUNG PKWY STE 500
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-6473
Mailing Address - Country:US
Mailing Address - Phone:503-844-4325
Mailing Address - Fax:
Practice Address - Street 1:5035 NE ELAM YOUNG PKWY STE 500
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6473
Practice Address - Country:US
Practice Address - Phone:503-844-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC200055171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist