Provider Demographics
NPI:1982255048
Name:CROWE, STEPHANIE CHEYENNE (RD)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:CHEYENNE
Last Name:CROWE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4381 HANSON RD
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-7932
Mailing Address - Country:US
Mailing Address - Phone:360-901-4947
Mailing Address - Fax:
Practice Address - Street 1:11000 NE 33RD PL STE 340
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-1441
Practice Address - Country:US
Practice Address - Phone:866-233-2737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered