Provider Demographics
NPI:1730313263
Name:DURST, ERIN E (LCSW, MSW, QMHP)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:E
Last Name:DURST
Suffix:
Gender:F
Credentials:LCSW, MSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 NE 21ST AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2595
Mailing Address - Country:US
Mailing Address - Phone:503-213-3872
Mailing Address - Fax:
Practice Address - Street 1:1112 NE 21ST AVE STE 1
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-2595
Practice Address - Country:US
Practice Address - Phone:503-213-3872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical