Individual
KRYSTINA FAULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 438-4660
Mailing address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
24-QMHA-R-5705
OR
Other
Enumeration date
06/22/2017
Last updated
07/25/2024
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