Provider Demographics
NPI:1104382795
Name:CRAWFORD, ASHLEY LYNNE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:LYNNE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4978 LILAC DR
Mailing Address - Street 2:
Mailing Address - City:FREELAND
Mailing Address - State:WA
Mailing Address - Zip Code:98249-9487
Mailing Address - Country:US
Mailing Address - Phone:310-570-3569
Mailing Address - Fax:
Practice Address - Street 1:222 ANTHES AVE
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-5100
Practice Address - Country:US
Practice Address - Phone:360-207-1865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-19
Last Update Date:2019-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60746282103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist