Healthcare Provider Details

I. General information

NPI: 1508777087
Provider Name (Legal Business Name): EMMA CRACIUN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 MAIN ST STE A
VANCOUVER WA
98663-2258
US

IV. Provider business mailing address

304 NW 102ND ST
VANCOUVER WA
98685-5233
US

V. Phone/Fax

Practice location:
  • Phone: 360-480-7890
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number0019997
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number61457010
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: