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NPI Code Detail

MEDICARE: MS. PAMELA MONTAGUE CRUTCHFIELD LCSW

MEDICARE: MS. PAMELA MONTAGUE CRUTCHFIELD LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerL3066OR

General Provider Information

NPI Number : 1770688954
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. PAMELA MONTAGUE CRUTCHFIELD LCSW
Provider Business Mailing Address
First Line : 101 E 8TH ST STE 110
Second Line :
City : VANCOUVER
State : WA
Zip : 98660-3294
Country : US
Telephone Number : 503-866-1084
Fax Number :
Provider Business Practice Location Address
First Line : 101 E 8TH ST STE 110
Second Line :
City : VANCOUVER
State : WA
Zip : 98660-3294
Country : US
Telephone Number : 503-866-1084
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2006
Last Update Date : 03/03/2023

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Directions to “ MS. PAMELA MONTAGUE CRUTCHFIELD LCSW” Practice Location

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