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General NPI Number Information
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NPI Number | 1518059088
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Entity Type | Individual
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Provider Name | J R CROWN O.D.
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 311 N 4TH ST STE 104
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City | YAKIMA
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State | WA
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Zip | 98901-2467
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Country | US
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Telephone | 509-452-8301
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Fax |
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Provider Business Mailing Address
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Address Line | 21126 SE 28TH PL
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City | SAMMAMISH
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State | WA
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Zip | 98075-7417
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Country | US
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Telephone | 503-806-1382
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OD00004103
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License Number State | WA
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