MEDICARE: ADAM P CRAMER PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1528623709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAM P CRAMER PLLC

Provider Business Mailing Address
First Line	:	2407 PACIFIC AVE SE STE B
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98501-8806
Country	:	US
Telephone Number	:	253-640-5793
Fax Number	:

Provider Business Practice Location Address
First Line	:	104 W 4TH ST
Second Line	:
City	:	ABERDEEN
State	:	WA
Zip	:	98520-3932
Country	:	US
Telephone Number	:	360-532-7512
Fax Number	:

Authorized Official
Title or Position	:	OPERATIONS MANAGER
Name	:	MRS. TRACI LYNN ROLAND
Credential	:
Telephone Number	:	253-640-5793

Provider Enumeration Date	:	05/03/2019
Last Update Date	:	06/11/2019

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Directions to “ADAM P CRAMER PLLC ” Practice Location

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