| Doctor Name: | PHYLLIS ELZEA |
| NPI Number: | 1033351838 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.C.S.W. |
| License Number: | #721 |
| Business Practice Address: | 10700 Sw Beaverton Hillsdale Hwy Suite 525 Beaverton, OR - 970053019 |
| Business Phone Number: | 5032412276 |
| Business Fax Number: | |
| Mailing Address: | 2850 Sw Cedar Hills Blvd, #213 BEAVERTON |
| State: | OR |
| Postal Code: | 970051354 |
| Phone Number: | 5032412276 |
| Fax Number: | |
| NPI Enumeration Date: | 03/26/2009 |
| NPI Last Update Date: | 08/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | #721 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | OR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |