Healthcare Provider Details

I. General information

NPI: 1386803161
Provider Name (Legal Business Name): CHRISTINE L CRANK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2008
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 DELAWARE ST
LONGVIEW WA
98632-2367
US

IV. Provider business mailing address

PO BOX 2605
YAKIMA WA
98907-2605
US

V. Phone/Fax

Practice location:
  • Phone: 360-414-2385
  • Fax: 360-414-2386
Mailing address:
  • Phone: 509-454-4143
  • Fax: 509-454-3651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD221494
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD60315147
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: