Provider Demographics
NPI:1902061526
Name:YORK, EMILY E (PHD, MA)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:E
Last Name:YORK
Suffix:
Gender:F
Credentials:PHD, MA
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:E
Other - Last Name:YORK-CROWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, MA
Mailing Address - Street 1:PO BOX 4037
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-4037
Mailing Address - Country:US
Mailing Address - Phone:503-413-5089
Mailing Address - Fax:
Practice Address - Street 1:1040 NW 22ND AVE
Practice Address - Street 2:SUITE 520
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3057
Practice Address - Country:US
Practice Address - Phone:503-413-7557
Practice Address - Fax:503-413-6547
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1890103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service