Healthcare Provider Details

I. General information

NPI: 1720233125
Provider Name (Legal Business Name): TAMI ANN CRON CPO LPO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/26/2008
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 S COLUMBIAN WAY MAIL STOP S-117-PSAS
SEATTLE WA
98108-1532
US

IV. Provider business mailing address

1660 S COLUMBIAN WAY MAIL STOP S-117-PSAS
SEATTLE WA
98108-1532
US

V. Phone/Fax

Practice location:
  • Phone: 206-277-4400
  • Fax: 206-277-1243
Mailing address:
  • Phone: 206-277-4400
  • Fax: 206-277-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License NumberOI00000008
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1744P3200X
TaxonomyProsthetics Case Management
License NumberPS00000009
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: