Provider Demographics
NPI:1093066342
Name:CRABTREE, WILLIAM MARSHALL III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MARSHALL
Last Name:CRABTREE
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5639 HOOD ST
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3235
Mailing Address - Country:US
Mailing Address - Phone:509-607-4673
Mailing Address - Fax:503-650-7855
Practice Address - Street 1:5639 HOOD ST
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3235
Practice Address - Country:US
Practice Address - Phone:509-607-4673
Practice Address - Fax:503-650-7855
Is Sole Proprietor?:No
Enumeration Date:2012-09-26
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPI-0010778183500000X
WAIR 60281819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAIR 60281819OtherSTATE PHARMACY INTERN LICENSE
ORRPH-0013722OtherOR BOARD OF PHARMACY