Most Relevant Information
Provider Data
| NPI Number: | 1003290503 |
| Provider Name: | COLIN MCCRUDDEN MA, LPC |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | C3409 |
Most Important Dates
| Enumeration Date: | 07/14/2015 |
| Last Updated: | 09/15/2015 |
Provider Practice Location
650 NE HOLLADAY ST
SUITE # 1637
PORTLAND
OR
972322045
Practice Location Phone/Fax
| Phone: | 9712660208 |
| Fax: |
Provider Mailing Location
650 NE HOLLADAY ST
SUITE # 1600
PORTLAND
OR
972322045
Provider Mailing Phone/Fax
| Phone: | 5032018223 |
| Fax: |