Individual
JANIS IRENE CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
18650 SW BOONES FERRY RD STE 3, TUALATIN, OR 97062-8491
(503) 680-4734
Mailing address
3523 NE 45TH AVE, PORTLAND, OR 97213-1021
(307) 321-3212
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2629
OR
103TP0814X
Psychoanalysis Psychologist
C2629
OR
Other
Enumeration date
10/20/2012
Last updated
10/20/2012
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