Provider Demographics
NPI:1295022440
Name:CRANDALL, KRISTIN LEE (DPT)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:LEE
Last Name:CRANDALL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:27500 102ND AVE NW
Mailing Address - Street 2:STE 1
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-8092
Mailing Address - Country:US
Mailing Address - Phone:360-629-7528
Mailing Address - Fax:360-629-7528
Practice Address - Street 1:27500 102ND AVE NW
Practice Address - Street 2:STE 1
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-8092
Practice Address - Country:US
Practice Address - Phone:360-629-9768
Practice Address - Fax:360-629-6487
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2017-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60225086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist