Provider Demographics
NPI:1457729295
Name:DOUMANI, ELAINE (LCSW)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:DOUMANI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 S BOND AVE FL 9
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4501
Mailing Address - Country:US
Mailing Address - Phone:503-418-7730
Mailing Address - Fax:
Practice Address - Street 1:3303 S BOND AVE FL OR97239
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4501
Practice Address - Country:US
Practice Address - Phone:503-418-7730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-10
Last Update Date:2025-06-17
Deactivation Date:2025-05-20
Deactivation Code:
Reactivation Date:2025-06-11
Provider Licenses
StateLicense IDTaxonomies
ORL112931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical