Individual
STEPHANIE RENEE CROUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
615 SE CHKALOV DR, SUITE 7, VANCOUVER, WA 98683-5279
(360) 885-1767
(360) 885-1394
Mailing address
615 SE CHKALOV DR, SUITE 7, VANCOUVER, WA 98683-5279
(360) 885-1767
(360) 885-1394
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA00020903
WA
Other
Enumeration date
03/09/2007
Last updated
07/08/2007
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