Provider Demographics
NPI:1568976215
Name:CRAKER, DYLAN FRANCIS (MSW)
Entity Type:Individual
Prefix:MR
First Name:DYLAN
Middle Name:FRANCIS
Last Name:CRAKER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 SW 136TH STREET
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166
Mailing Address - Country:US
Mailing Address - Phone:206-257-6648
Mailing Address - Fax:206-257-6828
Practice Address - Street 1:1210 SW 136TH STREET
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166
Practice Address - Country:US
Practice Address - Phone:206-257-6648
Practice Address - Fax:206-257-6828
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2018-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
RICSW02127104100000X
WASC60907423104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor