Provider Demographics
NPI:1811715808
Name:CREW, KATHLEEN LYN (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:LYN
Last Name:CREW
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1246 DOLA ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-1410
Mailing Address - Country:US
Mailing Address - Phone:541-852-5585
Mailing Address - Fax:541-393-5984
Practice Address - Street 1:44 CLUB RD STE 200
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2460
Practice Address - Country:US
Practice Address - Phone:541-972-6302
Practice Address - Fax:541-393-5984
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR201391736RN163WP0200X
OR10036280363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics