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General NPI Number Information
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NPI Number | 1619275864
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Entity Type | Individual
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Provider Name | ANTHONY JAMES KREZINSKI MS, MFT, AT
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Gender | Male
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Dates
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Enumeration Date | 03/10/2011
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Last Update Date | 03/10/2011
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Provider Practice Location Address
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Address Line | 1500 NE IRVING ST SUITE 250
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City | PORTLAND
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State | OR
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Zip | 97232-2243
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Country | US
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Telephone | 503-258-4200
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Fax |
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Provider Business Mailing Address
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Address Line | 3630 SE CESAR E CHAVEZ BLVD APT 16
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City | PORTLAND
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State | OR
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Zip | 97202-1700
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Country | US
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Telephone | 608-334-9499
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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