Provider Demographics
NPI:1033367644
Name:CRAWFORD, STEPHANIE K (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:K
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 NW BETHANY BLVD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-5208
Mailing Address - Country:US
Mailing Address - Phone:503-346-0640
Mailing Address - Fax:503-346-8040
Practice Address - Street 1:1500 NW BETHANY BLVD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-5208
Practice Address - Country:US
Practice Address - Phone:503-346-0640
Practice Address - Fax:503-346-8040
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1206235Z00000X
OR014012235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist