Provider Demographics
NPI:1992042139
Name:CROSBY, CHAD AARON (RPH)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:AARON
Last Name:CROSBY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8825 34TH AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:TULALIP
Mailing Address - State:WA
Mailing Address - Zip Code:98271
Mailing Address - Country:US
Mailing Address - Phone:360-716-2660
Mailing Address - Fax:360-716-3660
Practice Address - Street 1:8825 34TH AVE NE STE A
Practice Address - Street 2:
Practice Address - City:QUIL CEDA VILLAGE
Practice Address - State:WA
Practice Address - Zip Code:98271-8085
Practice Address - Country:US
Practice Address - Phone:360-716-2660
Practice Address - Fax:360-716-3660
Is Sole Proprietor?:No
Enumeration Date:2013-01-08
Last Update Date:2017-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000192971835P0018X, 1835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear