Healthcare Provider Details

I. General information

NPI: 1841168515
Provider Name (Legal Business Name): AMY CROW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2025
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 NW BETHANY BLVD STE 320
BEAVERTON OR
97006-5238
US

IV. Provider business mailing address

20540 COLONIAL ISLE DR UNIT 204
TAMPA FL
33647-3702
US

V. Phone/Fax

Practice location:
  • Phone: 503-567-3260
  • Fax: 503-567-3264
Mailing address:
  • Phone: 817-507-8806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL18278
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW25494
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: