Provider Demographics
NPI:1386978880
Name:ENO, CRYSTAL LYNN (DPT)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:LYNN
Last Name:ENO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CRYSTAL
Other - Middle Name:LYNN
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3121 SQUALICUM PKWY
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1937
Mailing Address - Country:US
Mailing Address - Phone:360-734-6760
Mailing Address - Fax:360-752-0660
Practice Address - Street 1:3121 SQUALICUM PKWY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1937
Practice Address - Country:US
Practice Address - Phone:360-734-6760
Practice Address - Fax:360-752-0660
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPU60113641225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist