Provider Demographics
NPI:1174679039
Name:CRAWFORD, CYNTHIA L (CFM)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:CFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-2331
Mailing Address - Country:US
Mailing Address - Phone:541-345-9204
Mailing Address - Fax:541-345-9204
Practice Address - Street 1:335 PEARL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2331
Practice Address - Country:US
Practice Address - Phone:541-345-9204
Practice Address - Fax:541-345-9204
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR297881OtherOMAP OHP
OR048001000OtherBLUE CROSS EUGENE
OR048001000OtherBLUE CROSS EUGENE