Provider Demographics
NPI:1275372401
Name:CRAWSHAW, KATIE LYNN
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:LYNN
Last Name:CRAWSHAW
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 1:8704 CAIRO AVE
Mailing Address - Street 2:
Mailing Address - City:LATON
Mailing Address - State:CA
Mailing Address - Zip Code:93242-9614
Mailing Address - Country:US
Mailing Address - Phone:559-670-0053
Mailing Address - Fax:
Practice Address - Street 1:875 PERIMETER DR # MS 2401
Practice Address - Street 2:
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83844-9803
Practice Address - Country:US
Practice Address - Phone:208-885-1673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-20
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No235500000XSpeech, Language and Hearing Service ProvidersSpecialist/Technologist