Individual
JESSICA RENAE CRADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
212 E CENTRAL AVE, SUITE 440, SPOKANE, WA 99208-6291
(509) 252-9602
(509) 789-9031
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60644738
WA
2084N0400X
Neurology Physician
Primary
MD60644738
WA
390200000X
Student in an Organized Health Care Education/Training Program
173365
NC
Other
Enumeration date
05/19/2011
Last updated
05/10/2018
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