Healthcare Provider Details

I. General information

NPI: 1336576859
Provider Name (Legal Business Name): DAWN MARIE CRAMER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2013
Last Update Date: 09/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 CAMPBELL RD
LONGVIEW WA
98632-9570
US

IV. Provider business mailing address

126 CAMPBELL RD
LONGVIEW WA
98632-9570
US

V. Phone/Fax

Practice location:
  • Phone: 360-577-4487
  • Fax:
Mailing address:
  • Phone: 360-577-4487
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN00102936
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: