Provider Demographics
NPI:1447740998
Name:MEMBER PLUS FAMILY HEALTH PLLC
Entity Type:Organization
Organization Name:MEMBER PLUS FAMILY HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:BLAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CRANDELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-842-3222
Mailing Address - Street 1:123 BJUNE DR SE STE 101
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2459
Mailing Address - Country:US
Mailing Address - Phone:206-842-3222
Mailing Address - Fax:206-842-1877
Practice Address - Street 1:123 BJUNE DR SE STE 101
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-2459
Practice Address - Country:US
Practice Address - Phone:206-842-3222
Practice Address - Fax:206-842-1877
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty