Provider Demographics
NPI:1285043323
Name:CROWLEY, CAMERON (LMP)
Entity type:Individual
Prefix:MS
First Name:CAMERON
Middle Name:
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 S 174TH PL # 310L
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98148-1676
Mailing Address - Country:US
Mailing Address - Phone:206-586-6748
Mailing Address - Fax:
Practice Address - Street 1:652 SW 150TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-4612
Practice Address - Country:US
Practice Address - Phone:206-657-7648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-02
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60483783225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist