MEDICARE: SHEILA M. CRANDLES LCSW

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	1041C0700X	Clinical Social Worker	L3266	OR

General Provider Information

NPI Number	:	1730199100
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA M. CRANDLES LCSW

Provider Business Mailing Address
First Line	:	1626 N COAST HWY
Second Line	:	SEATOWNE SHOPPING CENTER
City	:	NEWPORT
State	:	OR
Zip	:	97365-2357
Country	:	US
Telephone Number	:	541-265-5680
Fax Number	:

Provider Business Practice Location Address
First Line	:	1626 N COAST HWY
Second Line	:	SEATOWNE SHOPPING CENTER
City	:	NEWPORT
State	:	OR
Zip	:	97365-2357
Country	:	US
Telephone Number	:	541-265-5680
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	07/08/2007

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