Individual
MR. SEAN DOMINIC CRESAP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.P.O.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
WA
1744P3200X
Prosthetics Case Management
Primary
PS00000162
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8419053
—
WA
Enumeration date
10/01/2007
Last updated
10/01/2007
Update your record
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