Provider Demographics
NPI:1699653246
Name:CRAWFORD, JAMIE (CHT , RM, SHAM)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CHT , RM, SHAM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11522 NE KLICKITAT ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-1621
Mailing Address - Country:US
Mailing Address - Phone:503-730-8651
Mailing Address - Fax:
Practice Address - Street 1:11522 NE KLICKITAT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-1621
Practice Address - Country:US
Practice Address - Phone:503-730-8651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-22
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist