Provider Demographics
NPI:1235482266
Name:CRAPSER, NICHOLAS MATHIAS THOMAS (MA)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:MATHIAS THOMAS
Last Name:CRAPSER
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10920 SW BARBUR BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-8600
Mailing Address - Country:US
Mailing Address - Phone:360-442-1451
Mailing Address - Fax:
Practice Address - Street 1:10920 SW BARBUR BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-8600
Practice Address - Country:US
Practice Address - Phone:360-442-1451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60327803101YA0400X
OR15-R-27101YA0400X
WA60722084101YM0800X
ORC-4563101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health