Provider Demographics
NPI:1487260725
Name:WESTFALL, ELIZABETH CORTEZ (LICSWA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CORTEZ
Last Name:WESTFALL
Suffix:
Gender:F
Credentials:LICSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 SE CABOT DR STE B102
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3740
Mailing Address - Country:US
Mailing Address - Phone:360-675-5555
Mailing Address - Fax:360-675-0275
Practice Address - Street 1:275 SE CABOT DR STE B102
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3740
Practice Address - Country:US
Practice Address - Phone:360-675-5555
Practice Address - Fax:360-675-0275
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC610813411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical