Individual
CRYSTAL LEE COBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8915 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3690
Mailing address
8915 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3690
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/19/2019
Last updated
03/17/2020
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