=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851550982
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIANA CRANE COUNSELING
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/04/2008
-----------------------------------------------------
Last Update Date | 03/27/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8600 SW 10TH AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97219-4524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-713-9348
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8600 SW 10TH AVE
-----------------------------------------------------
City | PORTLAND
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97219-4524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-713-9541
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGISTERED ASSOCIATE THERAPIST
-----------------------------------------------------
Name | MISS DIANA CRANE
-----------------------------------------------------
Credential | MA
-----------------------------------------------------
Telephone | 509-713-9348
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OR
-----------------------------------------------------