Provider Demographics
NPI:1356633119
Name:CRAWFORD, ZOE M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ZOE
Middle Name:M
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 NW MARSHALL ST
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2949
Mailing Address - Country:US
Mailing Address - Phone:503-941-8908
Mailing Address - Fax:
Practice Address - Street 1:2455 NW MARSHALL ST
Practice Address - Street 2:SUITE 10
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2949
Practice Address - Country:US
Practice Address - Phone:503-941-8908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-11
Last Update Date:2016-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical