Individual
CRYSTAL ROSE TEMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
(503) 366-4526
Mailing address
58646 MCNULTY WAY, SAINT HELENS, OR 97051-6210
(503) 397-5211
(503) 366-4526
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
195164
—
OR
Enumeration date
01/30/2014
Last updated
10/10/2016
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