Individual
DANA LEE CRAWFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3024 NE 63RD AVE, PORTLAND, OR 97213-4510
(971) 606-3373
Mailing address
3024 NE 63RD AVE, PORTLAND, OR 97213-4510
(971) 606-3373
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
11862
OR
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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