MEDICARE: MR. CHRISTOPHER LEWIS CRAFT FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	12014	TN
2	363LF0000X	Family Nurse Practitioner	201400385NP-PP	OR

General Provider Information

NPI Number	:	1598723918
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHRISTOPHER LEWIS CRAFT FNP-BC

Provider Business Mailing Address
First Line	:	PO BOX 3397
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3397
Country	:	US
Telephone Number	:	503-717-7443
Fax Number	:

Provider Business Practice Location Address
First Line	:	171 N LARCH ST STE 16
Second Line	:
City	:	CANNON BEACH
State	:	OR
Zip	:	97110-3103
Country	:	US
Telephone Number	:	503-717-7402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	01/02/2025

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