Individual
AMANDA KRUSZKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
17200 NW CORRIDOR CT STE 110, BEAVERTON, OR 97006-3295
(503) 656-9030
Mailing address
7320 SW HUNZIKER RD STE 300, PORTLAND, OR 97223-2302
(503) 941-3077
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6628
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500715554
—
OR
Enumeration date
10/04/2016
Last updated
03/25/2020
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