Provider Demographics
NPI:1043202021
Name:CRANNEY, DEAN ROSS (MD)
Entity Type:Individual
Prefix:
First Name:DEAN
Middle Name:ROSS
Last Name:CRANNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 E 29TH AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3949
Mailing Address - Country:US
Mailing Address - Phone:509-673-7221
Mailing Address - Fax:509-572-9243
Practice Address - Street 1:2020 E 29TH AVE STE 235
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-3949
Practice Address - Country:US
Practice Address - Phone:509-673-7221
Practice Address - Fax:509-572-9243
Is Sole Proprietor?:No
Enumeration Date:2005-08-17
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00047878207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMD00047878OtherMEDICAL LICENSE