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General NPI Number Information
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NPI Number | 1487890083
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Entity Type | Individual
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Provider Name | CHANA DELOYCE CRAWFORD RN, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 1718 BROADWAY
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City | EVERETT
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State | WA
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Zip | 98201-2347
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Country | US
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Telephone | 425-212-4211
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Fax | 425-347-0492
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Provider Business Mailing Address
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Address Line | 906 SE EVERETT MALL WAY STE 200
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City | EVERETT
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State | WA
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Zip | 98208-3743
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Country | US
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Telephone | 425-353-5656
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Fax | 425-513-2807
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61579869
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN00104452
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License Number State | WA
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