Individual
JACOB KENDALL CRUMLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(985) 324-0464
Mailing address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(503) 239-5738
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
11/22/2022
Last updated
05/25/2023
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