Provider Information for 1578835104
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
CRYSTAL SHARIFI MSW
Sex: Female
NPI: 1578835104
Last Updated: 2024-04-01
Certification Date: 2024-04-01
Certification Date: 2024-04-01
Details
Name | Value | ||||||||
---|---|---|---|---|---|---|---|---|---|
NPI | 1578835104 | ||||||||
Enumeration Date | 2012-01-27 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 80 GALEN ST LAKE OSWEGO, OR 97035-2304 United States Phone: | Fax: | ||||||||
Primary Practice Address | 11010 SE DIVISION ST # 202 PORTLAND, OR 97266-6400 United States Phone: 503-335-5975 | Fax: | ||||||||
Secondary Practice Address(es) | |||||||||
Health Information Exchange |
| ||||||||
Other Identifiers |
| ||||||||
Taxonomy |
|