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Crystal Lee Coburn
Peer Specialist in Tigard, Oregon
NPI 1366099004

Crystal Lee Coburn is a Peer Specialist based in Tigard, OR. Crystal Lee Coburn practices in Tigard, OR. The NPI Number for Crystal Lee Coburn is 1366099004 and holds a License No. (Oregon).

The current practice location address for Crystal Lee Coburn is 8915 Sw Center St, Tigard, OR and can be reached out via phone at 503-726-3690.

Location: 8915 Sw Center St, Tigard, OR, 97223-6307
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1366099004
Provider Name
Crystal Lee Coburn
Credential
Provider Entity Type
Individual
Gender
Female
Address
8915 Sw Center St, Tigard, OR, 97223-6307
Phone Number
503-726-3690
Fax Number
Provider Enumeration Date
08/19/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
8915 Sw Center St
City
Tigard
State
Oregon
Zip
97223-6307
Phone Number
503-726-3690
Fax Number
person
Provider Business Mailing Address Details
Address
8915 Sw Center St
City
Tigard
State
Oregon
Zip
97223-6307
Phone Number
503-726-3690
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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