Provider Demographics
NPI:1912944786
Name:CRAWFORD, DOUGLAS W (DO)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:W
Last Name:CRAWFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 TORBETT ST
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-2604
Mailing Address - Country:US
Mailing Address - Phone:509-946-1695
Mailing Address - Fax:509-946-7666
Practice Address - Street 1:310 TORBETT ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2604
Practice Address - Country:US
Practice Address - Phone:509-946-1695
Practice Address - Fax:509-946-7666
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8138356Medicaid
WA0122619OtherLABOR & INDUSTRIES
WA8138356Medicaid
WA0122619OtherLABOR & INDUSTRIES