Healthcare Provider Details

I. General information

NPI: 1659450948
Provider Name (Legal Business Name): ELIZABETH BARROWS FREEMAN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 12/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 N VANCOUVER AVE SUITE 255
PORTLAND OR
97227-1630
US

IV. Provider business mailing address

4806 SE 48TH AVE
PORTLAND OR
97206-4150
US

V. Phone/Fax

Practice location:
  • Phone: 503-413-4500
  • Fax: 503-413-5222
Mailing address:
  • Phone: 646-345-3441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number000967
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number201506658NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: