Provider Demographics
NPI:1487890083
Name:CRAWFORD, CHANA DELOYCE (RN, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:CHANA
Middle Name:DELOYCE
Last Name:CRAWFORD
Suffix:
Gender:F
Credentials:RN, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 SE EVERETT MALL WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-3743
Mailing Address - Country:US
Mailing Address - Phone:425-353-5656
Mailing Address - Fax:425-513-2807
Practice Address - Street 1:1718 BROADWAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2347
Practice Address - Country:US
Practice Address - Phone:425-212-4211
Practice Address - Fax:425-347-0492
Is Sole Proprietor?:No
Enumeration Date:2009-01-02
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61579869363LP0808X
WARN00104452163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse