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NPI Code Detail

MEDICARE: ELIZABETH BORT

MEDICARE: ELIZABETH BORT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist17728OR
2171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1801272067
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH BORT
Provider Business Mailing Address
First Line : 7204 SW DURHAM ROAD
Second Line : SUITE 100
City : PORTLAND
State : OR
Zip : 97224-7574
Country : US
Telephone Number : 503-941-9869
Fax Number : 503-352-5555
Provider Business Practice Location Address
First Line : 7204 SW DURHAM ROAD
Second Line : SUITE 100
City : PORTLAND
State : OR
Zip : 97224-7574
Country : US
Telephone Number : 503-941-9869
Fax Number : 503-352-5555
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2015
Last Update Date : 10/23/2023

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Directions to “ ELIZABETH BORT ” Practice Location

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