Individual
MRS. STEPHANIE CRYSTAL JENEE FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO 60693822
Contact information
Practice address
1231 NE 73RD AVE, PORTLAND, OR 97213-6110
(503) 467-1449
Mailing address
1231 NE 73RD AVE, PORTLAND, OR 97213-6110
(503) 467-1449
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60693822
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO60693822
CDPT
WA
Enumeration date
06/15/2017
Last updated
07/21/2022
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