Individual
MS. KEA MICHELLE CRANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4000
(541) 812-4126
Mailing address
1046 6TH AVE SW, ALBANY, OR 97321-1916
(541) 812-4000
(541) 812-4126
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
10862
MT
207Q00000X
Family Medicine Physician
C53395
CA
207Q00000X
Family Medicine Physician
MD 00047001
WA
207Q00000X
Family Medicine Physician
MD24290
OR
208M00000X
Hospitalist Physician
Primary
MD24290
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
50069545
—
OR
Enumeration date
03/03/2006
Last updated
07/21/2022
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