Provider Demographics
NPI:1033470042
Name:CROWE, HOLLYN SUE JOHANNA (DO)
Entity Type:Individual
Prefix:
First Name:HOLLYN
Middle Name:SUE JOHANNA
Last Name:CROWE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3950 KEENE RD
Mailing Address - Street 2:
Mailing Address - City:WEST RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99353-4901
Mailing Address - Country:US
Mailing Address - Phone:509-942-3130
Mailing Address - Fax:509-628-8335
Practice Address - Street 1:3950 KEENE RD
Practice Address - Street 2:
Practice Address - City:WEST RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99353
Practice Address - Country:US
Practice Address - Phone:509-942-3130
Practice Address - Fax:509-628-8335
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO170749208000000X
WAOP60854370208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics