Healthcare Provider Details

I. General information

NPI: 1518059088
Provider Name (Legal Business Name): J R CROWN O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER R CROWN OD

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 S PLUM ST
SEATTLE WA
98144-4711
US

IV. Provider business mailing address

2501 S PLUM ST
SEATTLE WA
98144-4711
US

V. Phone/Fax

Practice location:
  • Phone: 206-436-2228
  • Fax:
Mailing address:
  • Phone: 206-436-2228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOD00004103
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOD00004103
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: