Provider Demographics
NPI:1811686496
Name:CRAUDELL, HANNAH VICTORIA (SUDPT)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:VICTORIA
Last Name:CRAUDELL
Suffix:
Gender:F
Credentials:SUDPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:VICTORIA
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6005 TYEE DR SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7356
Mailing Address - Country:US
Mailing Address - Phone:360-464-6700
Mailing Address - Fax:
Practice Address - Street 1:807 W PINE ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-2562
Practice Address - Country:US
Practice Address - Phone:360-426-7664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)