Provider Demographics
NPI:1275829772
Name:CRABTREE, JEANNE (LMP)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13
Mailing Address - Street 2:
Mailing Address - City:LYNDEN
Mailing Address - State:WA
Mailing Address - Zip Code:98264-0013
Mailing Address - Country:US
Mailing Address - Phone:360-354-6610
Mailing Address - Fax:
Practice Address - Street 1:8304 GUIDE MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-9151
Practice Address - Country:US
Practice Address - Phone:360-354-6610
Practice Address - Fax:360-318-8918
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5683173C00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No173C00000XOther Service ProvidersReflexologist