Provider Demographics
NPI:1689637563
Name:MCCRAVEY, MARTHA ALICE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:ALICE
Last Name:MCCRAVEY
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 1:45 N SUMMIT RD
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-7603
Mailing Address - Country:US
Mailing Address - Phone:253-752-7226
Mailing Address - Fax:
Practice Address - Street 1:314 MARTIN WAY
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4269
Practice Address - Country:US
Practice Address - Phone:253-403-1511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA223072080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine