Healthcare Provider Details

I. General information

NPI: 1225617053
Provider Name (Legal Business Name): WENDY J CRAGE FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 E HERSEY ST
ASHLAND OR
97520-1359
US

IV. Provider business mailing address

148 E HERSEY ST
ASHLAND OR
97520-1359
US

V. Phone/Fax

Practice location:
  • Phone: 541-326-4777
  • Fax: 541-708-6372
Mailing address:
  • Phone: 541-326-4777
  • Fax: 541-708-6372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95016612
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: