Provider Demographics
NPI:1487753398
Name:CRAIG, ARLEN SCOTT (PHD, LP)
Entity type:Individual
Prefix:DR
First Name:ARLEN
Middle Name:SCOTT
Last Name:CRAIG
Suffix:
Gender:M
Credentials:PHD, LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12962 SE 136TH DR
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-4300
Mailing Address - Country:US
Mailing Address - Phone:248-953-2900
Mailing Address - Fax:586-218-8678
Practice Address - Street 1:890 82ND DR
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:OR
Practice Address - Zip Code:97027-1803
Practice Address - Country:US
Practice Address - Phone:503-659-5515
Practice Address - Fax:503-212-2292
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2315103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical