Healthcare Provider Details

I. General information

NPI: 1740894518
Provider Name (Legal Business Name): ELIZABETH MEGHAN PALMER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEGHAN PALMER

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 SW RAMSEY AVE
GRANTS PASS OR
97527-5529
US

IV. Provider business mailing address

1215 SW G ST
GRANTS PASS OR
97526-2544
US

V. Phone/Fax

Practice location:
  • Phone: 541-476-2373
  • Fax: 503-335-5974
Mailing address:
  • Phone: 541-476-2373
  • Fax: 503-335-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: