Provider Demographics
NPI:1639168941
Name:HUNT, CRAIG TERRILL
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:TERRILL
Last Name:HUNT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 W 5TH AVE
Mailing Address - Street 2:STE 317
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2823
Mailing Address - Country:US
Mailing Address - Phone:509-747-8000
Mailing Address - Fax:509-747-8051
Practice Address - Street 1:801 W 5TH AVE
Practice Address - Street 2:STE 317
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2823
Practice Address - Country:US
Practice Address - Phone:509-747-8000
Practice Address - Fax:509-747-8051
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-19
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADI00000906133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAHU7845OtherASURIS IDENTIFIER