Provider Demographics
NPI:1043502719
Name:CROSTON, AMIEE
Entity Type:Individual
Prefix:
First Name:AMIEE
Middle Name:
Last Name:CROSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMIEE
Other - Middle Name:
Other - Last Name:LENG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 442
Mailing Address - Street 2:
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357-0442
Mailing Address - Country:US
Mailing Address - Phone:360-645-3317
Mailing Address - Fax:360-645-2972
Practice Address - Street 1:250 FORT STREET
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357
Practice Address - Country:US
Practice Address - Phone:360-645-3317
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-12
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00177363163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse