Provider Demographics
NPI:1609118439
Name:CROSKREY, JASON ALBERT (MD)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:ALBERT
Last Name:CROSKREY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:16010 E INDIANA AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-928-8040
Mailing Address - Fax:509-928-0784
Practice Address - Street 1:16010 E INDIANA AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216
Practice Address - Country:US
Practice Address - Phone:509-928-8040
Practice Address - Fax:509-928-0784
Is Sole Proprietor?:No
Enumeration Date:2013-03-19
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE28064207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2177277Medicaid