Individual
CRYSTAL WILKES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
1510 SE 88TH AVE, PORTLAND, OR 97216-1814
(503) 939-3760
Mailing address
1510 SE 88TH AVE, PORTLAND, OR 97216-1814
(503) 939-3760
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
C3417
OR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/20/2015
Last updated
10/25/2023
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