Active NPI
David Crouse
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1033638283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 16-CRM-237
- Practice address
- 33 NW Broadway
Portland, OR 97209-3580 - Phone
- (503) 228-7134
- Fax
- (503) 501-5679
- NPI assigned
- Sep 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 16-CRM-237 | OR | Primary |
Addresses
Primary practice location
33 NW Broadway
Portland, OR 97209-3580
Mailing address
232 NW 6TH Ave
Portland, OR 97209-3609
Phone (503) 501-5641
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16-CRM-237 | OR | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505779200000",
"number": "1033638283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 NW 6TH AVE",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093609",
"telephone_number": "503-501-5641",
"fax_number": "503-241-7419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 NW BROADWAY",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972093580",
"telephone_number": "503-228-7134",
"fax_number": "503-501-5679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CROUSE",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-19",
"last_updated": "2017-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OR",
"license": "16-CRM-237",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.