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General NPI Number Information
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NPI Number | 1285869958
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Entity Type | Organization
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Legal Business Name | CRESCENT PSYCHIATRY
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Dates
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Enumeration Date | 05/23/2009
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Last Update Date | 05/23/2009
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Provider Practice Location Address
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Address Line | 7191 WAGNER WAY NW SUITE # 301
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City | GIG HARBOR
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State | WA
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Zip | 98335-6909
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Country | US
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Telephone | 253-514-8076
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Fax | 253-514-8078
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Provider Business Mailing Address
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Address Line | 7191 WAGNER WAY NW SUITE # 301
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City | GIG HARBOR
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State | WA
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Zip | 98335-6909
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Country | US
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Telephone | 253-514-8076
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Fax | 253-514-8078
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VANRAJ VARU
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Credential | M.D.
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Telephone | 253-514-8076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | MD30816
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License Number State | WA
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