MEDICARE: MS. ELIZABETH A RICE L.M.T.

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
1	174400000X	Specialist	6912	OR

General Provider Information

NPI Number	:	1194867044
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH A RICE L.M.T.

Provider Business Mailing Address
First Line	:	1041 BEACH DR APT 3
Second Line	:
City	:	SEASIDE
State	:	OR
Zip	:	97138-5433
Country	:	US
Telephone Number	:	503-516-2135
Fax Number	:

Provider Business Practice Location Address
First Line	:	1041 BEACH DR APT 3
Second Line	:
City	:	SEASIDE
State	:	OR
Zip	:	97138-5433
Country	:	US
Telephone Number	:	503-516-2135
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	01/19/2010

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