Individual
KIMBERLY M CROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6018 SE STARK ST, PORTLAND, OR 97215-1990
(503) 505-6423
Mailing address
2314 SE ASH ST, PORTLAND, OR 97214-1634
(503) 505-6423
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
16-06-08
OR
101YM0800X
Mental Health Counselor
C5099
OR
101YP2500X
Professional Counselor
Primary
C5099
OR
Other
Enumeration date
09/08/2015
Last updated
12/28/2018
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