Quinn Elle Lake, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L7398 Issued in OR

Practice address

12008 SW Garden PL
Tigard, OR 97223-8263

Phone

(503) 352-9608

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Ms. Quinn Elle Kratovil Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1184216293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8623 SW HOLLY LN UNIT 707",
            "city": "WILSONVILLE",
            "state": "OR",
            "postal_code": "970708645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12008 SW GARDEN PL",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972238263",
            "telephone_number": "503-352-9608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAKE",
        "first_name": "QUINN",
        "middle_name": "ELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L7398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "QUINN",
            "last_name": "KRATOVIL",
            "middle_name": "ELLE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Rachel Lackey
• Amy Nicole Lacoste, DMD
• Lactation Consultants of America
• Dawn Michelle Lafollette
• Andrea Maria Lairson, PHYSICAL THERAPIST
• Vivian Lam, D.M.D
• Ann Marie Lamb
• Kyli Lamonica
• Steve A Lamont Jr., M.A. CRC LPC
• Suzanne Lamont, PTA, LMT, CYT

• Clinical Social Worker in Tigard, OR
• Providers in Tigard, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.