Provider Demographics
NPI:1578889218
Name:CRAMER, STEPHANIE K (MD)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:K
Last Name:CRAMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 SQUALICUM PKWY
Mailing Address - Street 2:STE 260
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1946
Mailing Address - Country:US
Mailing Address - Phone:360-733-4800
Mailing Address - Fax:360-733-2879
Practice Address - Street 1:3015 SQUALICUM PKWY
Practice Address - Street 2:STE 260
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1946
Practice Address - Country:US
Practice Address - Phone:360-733-4800
Practice Address - Fax:360-733-2879
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2019-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD165857207W00000X
390200000X
WAMD60883450207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500656256Medicaid
WA2027826Medicaid