Individual
CRATON HIGHWAYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6605 SE LAKE RD, MILWAUKIE, OR 97222-2161
(503) 477-3141
Mailing address
1606 VILLAGE PARK PL, WEST LINN, OR 97068-3932
(503) 477-3141
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/08/2022
Last updated
03/21/2024
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