Provider Demographics
NPI:1174809834
Name:CROWLEY, CAMARYN DIANE (LMP)
Entity type:Individual
Prefix:
First Name:CAMARYN
Middle Name:DIANE
Last Name:CROWLEY
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:CAMARYN
Other - Middle Name:DIANE
Other - Last Name:CURLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:785 E HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1257
Mailing Address - Country:US
Mailing Address - Phone:509-466-6393
Mailing Address - Fax:509-466-3072
Practice Address - Street 1:785 E HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1257
Practice Address - Country:US
Practice Address - Phone:509-466-6393
Practice Address - Fax:509-466-3072
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2017-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
590546-10225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist