Provider Demographics
NPI:1245825322
Name:CRAMER, JILLIAN DALY
Entity type:Individual
Prefix:
First Name:JILLIAN
Middle Name:DALY
Last Name:CRAMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14359 SE 6TH ST APT O203
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-7077
Mailing Address - Country:US
Mailing Address - Phone:206-240-1236
Mailing Address - Fax:
Practice Address - Street 1:14359 SE 6TH ST APT O203
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-7077
Practice Address - Country:US
Practice Address - Phone:206-240-1236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60906180163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse