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General NPI Number Information
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NPI Number | 1336947639
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Entity Type | Individual
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Provider Name | KANDICE LYNNETTE-ZOPHIA CROWN-PAYNE ARNP
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Gender | Female
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Dates
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Enumeration Date | 03/04/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 15418 MAIN ST UNIT 200
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City | MILL CREEK
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State | WA
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Zip | 98012-9030
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Country | US
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Telephone | 425-225-8000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5127
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City | EVERETT
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State | WA
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Zip | 98206-5127
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Country | US
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Telephone | 206-860-5414
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Fax | 206-720-8462
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN60864523
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP61671353
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License Number State | WA
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