Healthcare Provider Details

I. General information

NPI: 1063844918
Provider Name (Legal Business Name): CHELSEA LYNN CRANDELL OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 04/14/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 CASCADE LOOP
KALISPELL MT
59901-9581
US

IV. Provider business mailing address

PO BOX 9626
KALISPELL MT
59904-2626
US

V. Phone/Fax

Practice location:
  • Phone: 406-609-4939
  • Fax:
Mailing address:
  • Phone: 406-309-0236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2796
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: