Healthcare Provider Details

I. General information

NPI: 1306523402
Provider Name (Legal Business Name): ELIZABETH LUCCI-RIMER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2023
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14795 SW MURRAY SCHOLLS DR STE 121
BEAVERTON OR
97007-9713
US

IV. Provider business mailing address

17437 SW SEPTEMBER LN
BEAVERTON OR
97003-7549
US

V. Phone/Fax

Practice location:
  • Phone: 503-673-1071
  • Fax:
Mailing address:
  • Phone: 510-393-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4268
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: