Individual
JACOB LEROY CRAWFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
65 N HIGHWAY 101, WARRENTON, OR 97146-9371
(503) 325-5722
Mailing address
65 N HIGHWAY 101, WARRENTON, OR 97146-9371
(503) 325-5722
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
08/19/2024
Last updated
08/19/2024
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