| Eleni Lazarou | |
|
1720 Nw Lovejoy St Ste 302 Portland OR 97209-2344 | |
| (517) 488-5059 | |
| Not Available |
| Full Name | Eleni Lazarou |
|---|---|
| Speciality | Social Worker |
| Location | 1720 Nw Lovejoy St Ste 302, Portland, Oregon |
| Authorized Official Name and Position | Eleni Lazarou (OWNER) |
| Authorized Official Contact | 5174885059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eleni Lazarou 1720 Nw Lovejoy St Ste 302 Portland OR 97209-2344 Ph: (517) 488-5059 | Eleni Lazarou 1720 Nw Lovejoy St Ste 302 Portland OR 97209-2344 Ph: (517) 488-5059 |
| NPI Number | 1871102400 |
|---|---|
| Provider Enumeration Date | 07/29/2020 |
| Last Update Date | 04/27/2024 |
| Certification Date | 04/27/2024 |
| Medicare PECOS PAC ID | 5092125864 |
|---|---|
| Medicare Enrollment ID | O20201105001944 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871102400 | NPI | - | NPPES |
| 500764725 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Eleni Mae Lazarou |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174189856 PECOS PAC ID: 8729404124 Enrollment ID: I20200817000939 |
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