Provider Demographics
NPI:1457437345
Name:MCRAE, JOHN F (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:MCRAE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 SOUTH WALL ST.
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1938
Mailing Address - Country:US
Mailing Address - Phone:509-624-7253
Mailing Address - Fax:509-838-7196
Practice Address - Street 1:2206 SOUTH WALL ST.
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-1938
Practice Address - Country:US
Practice Address - Phone:509-624-7253
Practice Address - Fax:509-838-7196
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA793103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist