Provider Demographics
NPI:1568894541
Name:LOZIER, CRYSTAL CONSTANCE (PHD)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:CONSTANCE
Last Name:LOZIER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:CONSTANCE
Other - Last Name:LOZIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1050
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-0050
Mailing Address - Country:US
Mailing Address - Phone:503-545-2486
Mailing Address - Fax:
Practice Address - Street 1:3014 NE 278TH AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-9706
Practice Address - Country:US
Practice Address - Phone:503-545-2486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
WA60650636103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program