Provider Demographics
NPI:1093868366
Name:CROW, W. R (PHARM-D, CDM, CDE)
Entity Type:Individual
Prefix:
First Name:W.
Middle Name:R
Last Name:CROW
Suffix:
Gender:F
Credentials:PHARM-D, CDM, CDE
Other - Prefix:
Other - First Name:W.
Other - Middle Name:R
Other - Last Name:HUDGINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30819 47TH AVE S
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-2614
Mailing Address - Country:US
Mailing Address - Phone:253-833-9258
Mailing Address - Fax:
Practice Address - Street 1:17241 SE 272ND ST
Practice Address - Street 2:SUITE 124
Practice Address - City:COVINGTON
Practice Address - State:WA
Practice Address - Zip Code:98042-4965
Practice Address - Country:US
Practice Address - Phone:253-631-1200
Practice Address - Fax:253-631-7147
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA22499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist