Provider Demographics
NPI:1801150073
Name:CRAIG, EMILY MARIE (MS)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:MARIE
Last Name:CRAIG
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BELLWETHER WAY STE 107
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2961
Mailing Address - Country:US
Mailing Address - Phone:360-329-2055
Mailing Address - Fax:
Practice Address - Street 1:21 BELLWETHER WAY STE 107
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2961
Practice Address - Country:US
Practice Address - Phone:360-329-2055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-02
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2090756Medicaid