Provider Demographics
NPI:1780017525
Name:GARRISON, CRYSTAL LOUISE (ARNP/FAMILY PMHNP)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:LOUISE
Last Name:GARRISON
Suffix:
Gender:F
Credentials:ARNP/FAMILY PMHNP
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:LOUISE
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WA RN & OREGON RN
Mailing Address - Street 1:PO BOX 1600
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98668-1600
Mailing Address - Country:US
Mailing Address - Phone:360-256-2000
Mailing Address - Fax:360-514-1846
Practice Address - Street 1:400 NE MOTHER JOSEPH PL
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-3200
Practice Address - Country:US
Practice Address - Phone:360-256-2000
Practice Address - Fax:360-514-1846
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60355508363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner