=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427948108
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHAWN FARRIS-CROW LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/05/2025
-----------------------------------------------------
Last Update Date | 07/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 447 KILLIAN SPRING DR
-----------------------------------------------------
City | WOODBURN
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97071-5978
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-307-6803
-----------------------------------------------------
Fax | 888-336-2746
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8795 SW TUALATIN SHERWOOD RD # 1058
-----------------------------------------------------
City | TUALATIN
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97062-7529
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-307-6803
-----------------------------------------------------
Fax | 888-336-2746
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | C4375
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------