# MIDSTREAM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Portland Trauma Recovery
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285989822
- **Authorized official:** TARA CROWLEY LCSW (OFFICE MANAGER)
- **Authorized official phone:** (503) 715-0910

## Contact information

- **Practice address:** 1020 SW TAYLOR ST, SUITE 400, PORTLAND, OR 97205-2543
- **Practice address phone:** (503) 715-0910
- **Practice address fax:** (503) 715-0911
- **Mailing address:** 1020 SW TAYLOR ST, SUITE 400, PORTLAND, OR 97205-2543
- **Mailing address phone:** (503) 715-0910
- **Mailing address fax:** (503) 715-0911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | L5721 | OR | Yes |

## Other

- **Enumeration date:** 07/19/2012
- **Last updated:** 07/29/2014