Individual
CRAIG W BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1675 SW MARLOW AVE STE 110, PORTLAND, OR 97225-5102
(503) 297-7979
(503) 297-7980
Mailing address
1411 NE 16TH AVE APT 112, PORTLAND, OR 97232-4408
(510) 541-5311
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LCSW25164
CA
1041C0700X
Clinical Social Worker
Primary
L7315
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2107172
—
WA
05
—
500735648
—
OR
Enumeration date
05/19/2009
Last updated
03/03/2020
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