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1104042647
ELISHA M WATERS
PORTLAND, OR
NPI
1104042647
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR 060746)
Enumeration Date
2007-04-17
Last Update Date
2010-03-18
Business Address
-- ELISHA M WATERS BA, CADCI
9670 SW BEAVERTON HILLSDALE HWY
PORTLAND, OR 97282
Phone number: 503-626-9494
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Mailing Address
-- ELISHA M WATERS BA, CADCI
PO BOX 82819
PORTLAND, OR 97282-0819
Phone number: 503-626-9494
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