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NPI Code Detail

MEDICARE: CAROLYN CLAIRE CRAIG MD

MEDICARE: CAROLYN CLAIRE CRAIG MD
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
12084P0800XPsychiatry Physician210748AK

General Provider Information

NPI Number : 1598225351
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLYN CLAIRE CRAIG MD
Provider Business Mailing Address
First Line : PO BOX 3290
Second Line :
City : PORTLAND
State : OR
Zip : 97208-3290
Country : US
Telephone Number : 866-907-1068
Fax Number : 425-917-9141
Provider Business Practice Location Address
First Line : 1818 E REZANOF DR
Second Line :
City : KODIAK
State : AK
Zip : 99615-6505
Country : US
Telephone Number : 907-481-2400
Fax Number : 907-481-2419
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2019
Last Update Date : 09/08/2023

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