Provider Demographics
NPI:1811554199
Name:CRANFORD, ERIN LEE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LEE
Last Name:CRANFORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5734A NE MALLORY AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-2524
Mailing Address - Country:US
Mailing Address - Phone:503-310-6356
Mailing Address - Fax:
Practice Address - Street 1:3880 SE HARRISON ST
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-5899
Practice Address - Country:US
Practice Address - Phone:503-513-4665
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC191270171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist