Provider Demographics
NPI:1114670890
Name:CRACIUN, ANDREW PHILIP (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:PHILIP
Last Name:CRACIUN
Suffix:
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 1:3505 SE 192ND AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-1436
Mailing Address - Country:US
Mailing Address - Phone:360-253-3016
Mailing Address - Fax:
Practice Address - Street 1:3505 SE 192ND AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-1436
Practice Address - Country:US
Practice Address - Phone:360-253-3016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-01
Last Update Date:2022-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61204249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61204249OtherPHARMACIST LICENSE NUMBER