Provider Demographics
NPI:1740615848
Name:ASHLING, KRYSTAL KARIN (LCSW)
Entity Type:Individual
Prefix:
First Name:KRYSTAL
Middle Name:KARIN
Last Name:ASHLING
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 1:14155 SW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-3651
Mailing Address - Country:US
Mailing Address - Phone:503-547-9845
Mailing Address - Fax:
Practice Address - Street 1:14155 SW 6TH ST
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97005-3651
Practice Address - Country:US
Practice Address - Phone:503-547-9845
Practice Address - Fax:503-296-5843
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-08
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL1931SR1041C0700X
ORL19311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORL1931OtherOREGON STATE BOARD OF CLINICAL SOCIAL WORKERS
WALW00005506OtherINSURANCE PANELS