Individual
AMBER LANE CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PCA, QMHP
Contact information
Practice address
2415 SE 43RD AVE, PORTLAND, OR 97206-1600
(503) 208-3623
Mailing address
2415 SE 43RD AVE, PORTLAND, OR 97206-1600
(503) 208-3623
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
R6998
OR
Other
Enumeration date
09/08/2021
Last updated
04/11/2022
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